An initial examination of the associations between appearance-related safety behaviors, socioemotional, and body dysmorphia symptoms during adolescence.

INTRODUCTION: Adolescence is characterized by the onset of a relatively specific set of socioemotional disorders (i.e., depression, generalized anxiety disorder, social anxiety disorder, and eating disorders) as well as body dysmorphia symptoms. Appearance-related concerns are a central feature of these disorders. Emerging evidence in adults suggests that appearance-related safety behaviors may play an instrumental role in the onset and maintenance of a number of disorders. To date, no work has examined appearance-related safety behaviors during adolescence. The present study examined the extent to which appearance-related safety behaviors may be associated with socioemotional and body dysmorphia symptoms during adolescence. METHODS: Adolescents between the ages of 13 and 17 years old (N = 387, Mage = 14.82 years, 31.3% identified as male, 47.0% identified as female, and 19.1% identified as nonbinary/third gender, 2.6% declined to report gender identity) completed measures assessing negative affect, anxiety-relevant safety behavior use, cognitive reappraisal, expressive suppression, appearance-related safety behaviors, body dysmorphia symptoms, and socioemotional symptoms. Structural Equation Modeling was used to test hypotheses. RESULTS: The results of this study suggest that appearance-related safety behaviors evidenced associations with latent factors corresponding to affective (i.e., depression, generalized anxiety disorder, social anxiety), eating disorders, and body dysmorphia symptoms after controlling for previously established vulnerability factors. CONCLUSIONS: These findings demonstrate that appearance-related safety behaviors may evidence transdiagnostic associations with socioemotional symptoms and body dysmorphia symptoms during adolescence.

Assessing Diagnostic and Severity Grading Accuracy of Ultrasound Measurements for Carpal Tunnel Syndrome Compared to Electrodiagnostics.

BACKGROUND: The combined sensory index (CSI) is the most sensitive electrodiagnostic criteria for carpal tunnel syndrome (CTS), and the CSI and Bland criteria have been shown to predict surgical treatment outcomes. The proposed ultrasound measurements have not been assessed against the CSI for diagnostic accuracy and grading of CTS severity. OBJECTIVE: To investigate the use of ultrasound evaluations for both diagnosis and assessment of severity grading of CTS in comparison to electrodiagnostic assessment. DESIGN: All patients underwent an electrodiagnostic evaluation using the CSI and Bland severity grading. Each patient underwent an ultrasound evaluation including cross-sectional area (CSA), the change in CSA from the forearm to the tunnel (∆CSA), and the wrist-forearm ratio (WFR). These measurements were assessed for diagnostic and severity grading accuracy using the CSI as the gold standard. SETTING: Tertiary academic center. PARTICIPANTS: All patients referred for electrodiagnostic evaluation for CTS were eligible for the study. Only those with idiopathic CTS were included and those with prior CTS treatment were also excluded. Ninety-five patients were included in the study. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The primary study outcome measure was concordance between CSI diagnosis and severity categories and the ultrasound measurements. Both outcomes were also assessed using Bland criteria. RESULTS: Optimal cut-points for diagnosis of CTS were found to be CSA ≥12 mm2 , ∆CSA ≥4 mm2 , WFR ≥1.4. Using these cut-points, C-statistics comparing diagnosis of CTS using ultrasound measurements versus using the CSI ranged from 0.893-0.966. When looking at CSI severity grading compared to ∆CSA, however, the C-statistics were 0.640-0.661 with substantial overlap between severity groups. CONCLUSIONS: Although ultrasound measurements had high diagnostic accuracy for CTS based on the CSI criteria, ultrasound measurements were unable to adequately distinguish between CSI severity groups among patients with CTS.