1c3d47f7ee39839f5dc8ebd545c2da59 nutrientsv17a2025art3914.pdf e921e5655f366166bfb40e7b4173da4ec38b9ccb nutrientsv17a2025art3914.pdf a63f131403fbc5ce7be1835e234c3aa94050f75ff1e672657d8c96d38dd46b49 nutrientsv17a2025art3914.pdf Title: Eating Disorders in an Immigrant Population: Are Clinical Features and Treatment Outcomes Different from the Native-Born Spanish Population? Subject: Background/Objectives: Sociocultural factors, including migration and acculturation, may influence the clinical profile and course of eating disorders (EDs). This study examined differences between immigrant and native-born Spanish patients with EDs in (1) clinical presentation and (2) treatment response. Methods: Consecutive outpatients from the Eating Disorders Unit at Bellvitge University Hospital (Barcelona, Spain) were assessed using the Eating Disorder Inventory-2 (EDI-2), Symptom Checklist-90-R (SCL-90-R), and Temperament and Character Inventory-Revised (TCI-R). Statistical analyses included chi-square tests, ANOVA, Cox regression for dropout, and logistic regression for predictors of poor outcome, adjusted for ED subtype. Results: The sample included 1104 patients (947 native-born; 157 immigrants). Immigrant patients showed a distinct clinical profile, with lower drive for thinness and body dissatisfaction but higher interpersonal distrust, maturity fears, perfectionism, anxiety-related symptoms, and self-transcendence. They also presented a worse treatment response, including higher dropout rates, poorer outcomes, and lower remission rates. Predictive models identified different risk factors for poor treatment response in each group: among native-born patients, younger age of ED onset, higher novelty seeking, and lower self-directedness were associated with worse outcomes, whereas among immigrant patients, greater ED severity, lower harm avoidance, and lower self-transcendence predicted poorer results. Conclusions: Immigrant patients with EDs exhibit a differentiated clinical presentation and less favorable treatment response compared to native-born patients. The differential predictors of poor outcome highlight the need for culturally informed and individually tailored interventions that consider both sociocultural context and personality-related vulnerabilities.24pt Keywords: eating disorders; personality traits; immigrant; native-born; acculturation-6pt Author: Magda Rosinska, Silvia Tempia Valenta, Isabel Sánchez, Olga Jordana Ovejero, Teresa Alonzo-Castillo, Laura Gálvez Solé, Rosa Fontana Eito, Lucero Munguia, Elena Caravaca Sanz, Anna Rita Atti, Roser Granero, Susana Jiménez-Murcia and Fernando Fernández-Aranda Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25; modified using OpenPDF 1.4.2 CreationDate: Sun Dec 14 08:57:05 2025 CET ModDate: Sun Dec 14 15:37:19 2025 CET Custom Metadata: yes Metadata Stream: yes Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 16 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 2416241 bytes Optimized: yes PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- PUSKOG+URWPalladioL-Roma Type 1 Custom yes yes yes 598 0 MVWIXV+URWPalladioL-Bold Type 1 Custom yes yes yes 601 0 DXMPWL+URWPalladioL-Ital Type 1 Custom yes yes yes 604 0 EILUJF+CMSY10 Type 1 Builtin yes yes yes 350 0 ZIPEAN+EURM10 Type 1 Builtin yes yes yes 353 0 NBOERA+URWPalladioL-BoldItal Type 1 Custom yes yes yes 354 0 CIDFont+F2 CID TrueType Identity-H yes no yes 159 0 CIDFont+F2 CID TrueType Identity-H yes no yes 170 0 CIDFont+F4 CID TrueType Identity-H yes no yes 176 0 CIDFont+F5 CID TrueType Identity-H yes no yes 182 0 CIDFont+F6 CID TrueType Identity-H yes no yes 188 0 CIDFont+F7 CID TrueType Identity-H yes no yes 194 0 CIDFont+F1 CID TrueType Identity-H yes no yes 204 0 CIDFont+F2 CID TrueType Identity-H yes no yes 210 0 CIDFont+F4 CID TrueType Identity-H yes no yes 216 0 CIDFont+F6 CID TrueType Identity-H yes no yes 222 0 CIDFont+F7 CID TrueType Identity-H yes no yes 228 0 CIDFont+F5 CID TrueType Identity-H yes no yes 234 0 CIDFont+F1 CID TrueType Identity-H yes no yes 241 0 CIDFont+F2 CID TrueType Identity-H yes no yes 247 0 YGQLYD+VnURWPalladioL Type 1 Custom yes yes yes 360 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2026-01-11 03:09:18 CET RepresentationInformation: nutrientsv17a2025art3914.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2026-01-10 13:45:19 CET Size: 2416241 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf Profile: Linearized PDF PDFMetadata: Objects: 0 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: ViewerPreferences: HideToolbar: false HideMenubar: false HideWindowUI: false FitWindow: true CenterWindow: false DisplayDocTitle: false NonFullScreenPageMode: UseNone Direction: L2R ViewArea: CropBox ViewClip: CropBox PrintArea: CropBox PageClip: CropBox PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Item: Title: Materials and Methods Children: Item: Title: Participants and Procedure Item: Title: Treatment Item: Title: Assessment Children: Item: Title: Semi-Structured Clinical Interview Item: Title: Self-Report Measures Item: Title: Procedure and Ethics Item: Title: Statistical Analysis Item: Title: Results Children: Item: Title: Description of the Sample Item: Title: Differences in the Baseline Measures Between Immigrant and Native-Born Patients Item: Title: Differences in Treatment Outcomes Between Immigrant and Native-Born Patients Item: Title: Survival Curves for the Rate of Treatment Dropout Item: Title: Discussion Item: Title: Limitations and Strengths Item: Title: Conclusions Item: Title: References Filters: FilterPipeline: FlateDecode Fonts: Type1: Font: BaseFont: ZIPEAN+EURM10 FontSubset: true FirstChar: 11 LastChar: 31 FontDescriptor: FontName: ZIPEAN+EURM10 Flags: Symbolic FontBBox: -32, -243, 1060, 720 FontFile: true ToUnicode: true Font: BaseFont: NBOERA+URWPalladioL-BoldItal FontSubset: true FirstChar: 37 LastChar: 112 FontDescriptor: FontName: NBOERA+URWPalladioL-BoldItal Flags: Symbolic FontBBox: -170, -300, 1073, 935 FontFile: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: PUSKOG+URWPalladioL-Roma FontSubset: true FirstChar: 2 LastChar: 252 FontDescriptor: FontName: PUSKOG+URWPalladioL-Roma Flags: Symbolic FontBBox: -166, -283, 1021, 943 FontFile: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: YGQLYD+VnURWPalladioL FontSubset: true FirstChar: 146 LastChar: 160 FontDescriptor: FontName: YGQLYD+VnURWPalladioL Flags: Symbolic FontBBox: -166, -283, 1021, 943 FontFile: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: MVWIXV+URWPalladioL-Bold FontSubset: true FirstChar: 3 LastChar: 233 FontDescriptor: FontName: MVWIXV+URWPalladioL-Bold Flags: Symbolic FontBBox: -152, -301, 1000, 935 FontFile: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: DXMPWL+URWPalladioL-Ital FontSubset: true FirstChar: 40 LastChar: 241 FontDescriptor: FontName: DXMPWL+URWPalladioL-Ital Flags: Symbolic FontBBox: -170, -305, 1010, 941 FontFile: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: EILUJF+CMSY10 FontSubset: true FirstChar: 0 LastChar: 21 FontDescriptor: FontName: EILUJF+CMSY10 Flags: Symbolic FontBBox: -29, -960, 1116, 775 FontFile: true ToUnicode: true XMP: application/pdf Magda Rosinska, Silvia Tempia Valenta, Isabel Sánchez, Olga Jordana Ovejero, Teresa Alonzo-Castillo, Laura Gálvez Solé, Rosa Fontana Eito, Lucero Munguia, Elena Caravaca Sanz, Anna Rita Atti, Roser Granero, Susana Jiménez-Murcia and Fernando Fernández-Aranda Background/Objectives: Sociocultural factors, including migration and acculturation, may influence the clinical profile and course of eating disorders (EDs). This study examined differences between immigrant and native-born Spanish patients with EDs in (1) clinical presentation and (2) treatment response. Methods: Consecutive outpatients from the Eating Disorders Unit at Bellvitge University Hospital (Barcelona, Spain) were assessed using the Eating Disorder Inventory-2 (EDI-2), Symptom Checklist-90-R (SCL-90-R), and Temperament and Character Inventory-Revised (TCI-R). Statistical analyses included chi-square tests, ANOVA, Cox regression for dropout, and logistic regression for predictors of poor outcome, adjusted for ED subtype. Results: The sample included 1104 patients (947 native-born; 157 immigrants). Immigrant patients showed a distinct clinical profile, with lower drive for thinness and body dissatisfaction but higher interpersonal distrust, maturity fears, perfectionism, anxiety-related symptoms, and self-transcendence. They also presented a worse treatment response, including higher dropout rates, poorer outcomes, and lower remission rates. Predictive models identified different risk factors for poor treatment response in each group: among native-born patients, younger age of ED onset, higher novelty seeking, and lower self-directedness were associated with worse outcomes, whereas among immigrant patients, greater ED severity, lower harm avoidance, and lower self-transcendence predicted poorer results. Conclusions: Immigrant patients with EDs exhibit a differentiated clinical presentation and less favorable treatment response compared to native-born patients. The differential predictors of poor outcome highlight the need for culturally informed and individually tailored interventions that consider both sociocultural context and personality-related vulnerabilities.24pt Eating Disorders in an Immigrant Population: Are Clinical Features and Treatment Outcomes Different from the Native-Born Spanish Population? 2025-12-14T15:57:05+08:00 LaTeX with hyperref 2025-12-14T15:37:19+01:00 2025-12-14T15:37:19+01:00 eating disorders; personality traits; immigrant; native-born; acculturation-6pt pdfTeX-1.40.25; modified using OpenPDF 1.4.2 False This is pdfTeX, Version 3.141592653-2.6-1.40.25 (TeX Live 2023) kpathsea version 6.3.5 uuid:65cafe93-8cc7-420c-8cce-60bc8911203e uuid:58f5e68f-a4bb-438a-979c-d480eab058cd Pages: Page: Sequence: 1 Annotations: Annotation: Subtype: Link Rect: 63, 177, 152, 186 Annotation: Subtype: Link Rect: 34, 167, 72, 174 Annotation: Subtype: Link Rect: 36, 75, 152, 84 Annotation: Subtype: Link Rect: 34, 63, 89, 72 Annotation: Subtype: Link Rect: 34, 773, 141, 809 Annotation: Subtype: Link Rect: 515, 773, 560, 809 Annotation: Subtype: Link Rect: 262, 643, 273, 656 Annotation: Subtype: Link Rect: 488, 643, 499, 656 Annotation: Subtype: Link Rect: 440, 629, 451, 642 Annotation: Subtype: Link Rect: 198, 615, 209, 628 Annotation: Subtype: Link Rect: 347, 615, 358, 628 Annotation: Subtype: Link Rect: 542, 615, 554, 628 Annotation: Subtype: Link Rect: 426, 27, 560, 37 Annotation: Subtype: Link Rect: 34, 379, 87, 398 Page: Sequence: 2 Annotations: Annotation: Subtype: Link Rect: 541, 695, 548, 704 ActionDest: 79 Annotation: Subtype: Link Rect: 549, 695, 556, 704 ActionDest: 79 Annotation: Subtype: Link Rect: 339, 667, 346, 676 ActionDest: 79 Annotation: Subtype: Link Rect: 331, 639, 338, 648 ActionDest: 79 Annotation: Subtype: Link Rect: 339, 639, 346, 648 ActionDest: 79 Annotation: Subtype: Link Rect: 450, 611, 457, 620 ActionDest: 79 Annotation: Subtype: Link Rect: 526, 597, 533, 606 ActionDest: 79 Annotation: Subtype: Link Rect: 307, 583, 314, 592 ActionDest: 79 Annotation: Subtype: Link Rect: 406, 555, 413, 564 ActionDest: 79 Annotation: Subtype: Link Rect: 413, 555, 420, 564 ActionDest: 79 Annotation: Subtype: Link Rect: 296, 527, 308, 537 ActionDest: 79 Annotation: Subtype: Link Rect: 308, 528, 320, 537 ActionDest: 79 Annotation: Subtype: Link Rect: 299, 472, 311, 481 ActionDest: 79 Annotation: Subtype: Link Rect: 314, 472, 326, 481 ActionDest: 79 Annotation: Subtype: Link Rect: 238, 430, 250, 439 ActionDest: 79 Annotation: Subtype: Link Rect: 253, 430, 265, 439 ActionDest: 79 Annotation: Subtype: Link Rect: 531, 402, 543, 411 ActionDest: 82 Annotation: Subtype: Link Rect: 544, 402, 556, 411 ActionDest: 82 Annotation: Subtype: Link Rect: 246, 374, 258, 383 ActionDest: 82 Annotation: Subtype: Link Rect: 462, 347, 474, 356 ActionDest: 82 Annotation: Subtype: Link Rect: 450, 319, 462, 328 ActionDest: 82 Annotation: Subtype: Link Rect: 308, 277, 320, 286 ActionDest: 82 Annotation: Subtype: Link Rect: 320, 277, 332, 286 ActionDest: 82 Annotation: Subtype: Link Rect: 310, 249, 322, 258 ActionDest: 82 Annotation: Subtype: Link Rect: 323, 249, 335, 258 ActionDest: 82 Annotation: Subtype: Link Rect: 519, 221, 531, 230 ActionDest: 82 Page: Sequence: 3 Annotations: Annotation: Subtype: Link Rect: 208, 669, 220, 679 ActionDest: 82 Annotation: Subtype: Link Rect: 196, 601, 208, 610 ActionDest: 82 Annotation: Subtype: Link Rect: 208, 601, 220, 610 ActionDest: 82 Annotation: Subtype: Link Rect: 380, 531, 392, 541 ActionDest: 82 Annotation: Subtype: Link Rect: 393, 531, 405, 541 ActionDest: 82 Annotation: Subtype: Link Rect: 202, 297, 214, 306 ActionDest: 82 Annotation: Subtype: Link Rect: 356, 283, 368, 292 ActionDest: 82 Annotation: Subtype: Link Rect: 291, 213, 303, 222 ActionDest: 82 Annotation: Subtype: Link Rect: 377, 185, 389, 194 ActionDest: 82 Annotation: Subtype: Link Rect: 388, 102, 400, 111 ActionDest: 82 Page: Sequence: 4 Annotations: Annotation: Subtype: Link Rect: 448, 758, 460, 767 ActionDest: 82 Annotation: Subtype: Link Rect: 195, 689, 207, 698 ActionDest: 82 Annotation: Subtype: Link Rect: 544, 620, 556, 629 ActionDest: 82 Page: Sequence: 5 Annotations: Annotation: Subtype: Link Rect: 329, 569, 336, 581 ActionDest: 12 Page: Sequence: 6 Annotations: Annotation: Subtype: Link Rect: 248, 725, 255, 737 ActionDest: 15 Annotation: Subtype: Link Rect: 238, 711, 245, 723 ActionDest: 18 Annotation: Subtype: Link Rect: 408, 711, 415, 723 ActionDest: 31 Page: Sequence: 7 Page: Sequence: 8 Annotations: Annotation: Subtype: Link Rect: 416, 469, 422, 481 ActionDest: 31 Annotation: Subtype: Link Rect: 473, 469, 480, 481 ActionDest: 45 Annotation: Subtype: Link Rect: 488, 134, 495, 146 ActionDest: 45 Page: Sequence: 9 Annotations: Annotation: Subtype: Link Rect: 191, 756, 198, 769 ActionDest: 45 Annotation: Subtype: Link Rect: 528, 358, 535, 370 ActionDest: 45 Page: Sequence: 10 Annotations: Annotation: Subtype: Link Rect: 221, 700, 233, 709 ActionDest: 82 Annotation: Subtype: Link Rect: 465, 379, 477, 388 ActionDest: 82 Annotation: Subtype: Link Rect: 477, 379, 489, 388 ActionDest: 85 Annotation: Subtype: Link Rect: 263, 352, 275, 361 ActionDest: 82 Annotation: Subtype: Link Rect: 276, 352, 288, 361 ActionDest: 85 Annotation: Subtype: Link Rect: 230, 324, 242, 333 ActionDest: 82 Annotation: Subtype: Link Rect: 242, 324, 254, 333 ActionDest: 85 Annotation: Subtype: Link Rect: 534, 296, 546, 305 ActionDest: 82 Annotation: Subtype: Link Rect: 544, 198, 556, 207 ActionDest: 85 Annotation: Subtype: Link Rect: 375, 170, 387, 180 ActionDest: 85 Annotation: Subtype: Link Rect: 449, 143, 461, 152 ActionDest: 79 Annotation: Subtype: Link Rect: 307, 115, 318, 124 ActionDest: 85 Annotation: Subtype: Link Rect: 244, 73, 255, 82 ActionDest: 85 Page: Sequence: 11 Annotations: Annotation: Subtype: Link Rect: 220, 689, 232, 698 ActionDest: 85 Annotation: Subtype: Link Rect: 233, 689, 245, 698 ActionDest: 85 Annotation: Subtype: Link Rect: 202, 661, 214, 670 ActionDest: 85 Annotation: Subtype: Link Rect: 494, 633, 506, 642 ActionDest: 85 Annotation: Subtype: Link Rect: 332, 563, 344, 572 ActionDest: 85 Annotation: Subtype: Link Rect: 344, 563, 356, 572 ActionDest: 85 Annotation: Subtype: Link Rect: 281, 480, 293, 489 ActionDest: 85 Annotation: Subtype: Link Rect: 365, 452, 377, 461 ActionDest: 85 Annotation: Subtype: Link Rect: 398, 424, 410, 433 ActionDest: 85 Annotation: Subtype: Link Rect: 193, 396, 205, 405 ActionDest: 85 Annotation: Subtype: Link Rect: 493, 354, 505, 364 ActionDest: 85 Annotation: Subtype: Link Rect: 505, 354, 517, 364 ActionDest: 85 Annotation: Subtype: Link Rect: 314, 257, 326, 266 ActionDest: 85 Annotation: Subtype: Link Rect: 441, 229, 453, 238 ActionDest: 85 Annotation: Subtype: Link Rect: 453, 229, 465, 238 ActionDest: 85 Page: Sequence: 12 Page: Sequence: 13 Annotations: Annotation: Subtype: Link Rect: 505, 661, 560, 672 Annotation: Subtype: Link Rect: 165, 648, 332, 659 Page: Sequence: 14 Annotations: Annotation: Subtype: Link Rect: 383, 529, 421, 540 Annotation: Subtype: Link Rect: 339, 465, 376, 476 Annotation: Subtype: Link Rect: 59, 427, 96, 437 Annotation: Subtype: Link Rect: 102, 427, 138, 437 Annotation: Subtype: Link Rect: 428, 401, 466, 412 Annotation: Subtype: Link Rect: 241, 375, 278, 386 Annotation: Subtype: Link Rect: 59, 300, 96, 310 Annotation: Subtype: Link Rect: 102, 300, 138, 310 Annotation: Subtype: Link Rect: 478, 273, 515, 284 Annotation: Subtype: Link Rect: 521, 273, 557, 284 Annotation: Subtype: Link Rect: 95, 236, 133, 246 Annotation: Subtype: Link Rect: 478, 209, 515, 220 Annotation: Subtype: Link Rect: 521, 209, 557, 220 Annotation: Subtype: Link Rect: 171, 184, 209, 195 Annotation: Subtype: Link Rect: 215, 184, 251, 195 Annotation: Subtype: Link Rect: 356, 158, 394, 169 Annotation: Subtype: Link Rect: 404, 133, 441, 144 Annotation: Subtype: Link Rect: 220, 94, 257, 105 Annotation: Subtype: Link Rect: 264, 94, 300, 105 Annotation: Subtype: Link Rect: 219, 69, 257, 80 Page: Sequence: 15 Annotations: Annotation: Subtype: Link Rect: 104, 731, 141, 742 Annotation: Subtype: Link Rect: 192, 692, 229, 703 Annotation: Subtype: Link Rect: 305, 654, 342, 665 Annotation: Subtype: Link Rect: 410, 603, 448, 614 Annotation: Subtype: Link Rect: 59, 578, 96, 588 Annotation: Subtype: Link Rect: 182, 552, 219, 563 Annotation: Subtype: Link Rect: 154, 526, 192, 537 Annotation: Subtype: Link Rect: 520, 501, 557, 512 Annotation: Subtype: Link Rect: 283, 475, 321, 486 Annotation: Subtype: Link Rect: 327, 475, 363, 486 Annotation: Subtype: Link Rect: 220, 412, 258, 422 Annotation: Subtype: Link Rect: 264, 412, 300, 422 Annotation: Subtype: Link Rect: 411, 373, 449, 384 Annotation: Subtype: Link Rect: 354, 335, 391, 346 Annotation: Subtype: Link Rect: 179, 297, 217, 307 Annotation: Subtype: Link Rect: 163, 272, 201, 282 Annotation: Subtype: Link Rect: 282, 118, 560, 129 Annotation: Subtype: Link Rect: 56, 105, 307, 116 Annotation: Subtype: Link Rect: 59, 67, 96, 78 Page: Sequence: 16 Annotations: Annotation: Subtype: Link Rect: 131, 744, 168, 754 Annotation: Subtype: Link Rect: 175, 744, 211, 754 Annotation: Subtype: Link Rect: 258, 719, 295, 729 Annotation: Subtype: Link Rect: 301, 719, 337, 729 Annotation: Subtype: Link Rect: 59, 693, 96, 703 Annotation: Subtype: Link Rect: 318, 667, 355, 678 Annotation: Subtype: Link Rect: 165, 629, 203, 639 Annotation: Subtype: Link Rect: 193, 603, 230, 614 Annotation: Subtype: Link Rect: 131, 578, 168, 588 Annotation: Subtype: Link Rect: 175, 578, 211, 588 Annotation: Subtype: Link Rect: 59, 553, 96, 563 Annotation: Subtype: Link Rect: 102, 553, 138, 563 Annotation: Subtype: Link Rect: 104, 514, 141, 524 Annotation: Subtype: Link Rect: 147, 514, 183, 524 Annotation: Subtype: Link Rect: 59, 489, 96, 499 Annotation: Subtype: Link Rect: 95, 463, 133, 473 Annotation: Subtype: Link Rect: 464, 450, 502, 461 Annotation: Subtype: Link Rect: 283, 424, 321, 435 Annotation: Subtype: Link Rect: 327, 424, 363, 435 Annotation: Subtype: Link Rect: 298, 373, 335, 384 Annotation: Subtype: Link Rect: 59, 348, 96, 358 Annotation: Subtype: Link Rect: 505, 322, 542, 333 Annotation: Subtype: Link Rect: 489, 296, 526, 307 Annotation: Subtype: Link Rect: 95, 259, 132, 269 Annotation: Subtype: Link Rect: 138, 259, 174, 269 Annotation: Subtype: Link Rect: 458, 245, 495, 256 Checksum: fa4221f3 Type: CRC32 Checksum: 1c3d47f7ee39839f5dc8ebd545c2da59 Type: MD5 Checksum: e921e5655f366166bfb40e7b4173da4ec38b9ccb Type: SHA-1 Checksum: a63f131403fbc5ce7be1835e234c3aa94050f75ff1e672657d8c96d38dd46b49 Type: SHA-256