Emotional difficulties mediate the impact of adverse childhood experiences on compulsive buying-shopping problems.

Background: Compulsive buying-shopping is recognised as a significant mental health concern, yet its aetiology is largely understudied. A known risk factor for compulsive buying-shopping is adverse childhood experiences (ACEs). ACEs are also associated with greater problems regulating emotions, as well as depression and anxiety. These factors are also known to be associated with compulsive buying-shopping problems. In this study, we aimed to test a serial mediation model in which ACEs were associated with compulsive buying-shopping problems via emotion dysregulation, and then emotional psychopathology (depression, anxiety). Methods: We tested this model cross-sectionally in two large samples (N = 1,868 & 4,742) to evaluate the robustness of the model. Both samples completed self-report measures of ACEs, emotional dysregulation, compulsive buying, depression, and anxiety symptoms. Results: We found support for indirect effects, and all results were consistent for both samples. ACEs predicted greater emotion dysregulation, which then predicted greater depression and anxiety. In turn, anxiety (but not depression) predicted compulsive buying symptoms. Discussion and conclusions: Emotion dysregulation and anxiety consistently mediated the relationship between ACEs and compulsive buying symptoms. Both emotion dysregulation and anxiety represent malleable targets in clinical interventions for compulsive buying-shopping problems. Our findings also suggest that anxiety may be a stronger predictor of compulsive buying compared to depression, which may be an important avenue for future researchers to investigate.

The correlates of appearance focused self-concept: personality traits, self-concept, sociocultural, and early life experience factors.

BACKGROUND: Theory and research indicate that an appearance focused self-concept (i.e., placing overriding importance on physical appearance for self-definition and self-worth) plays a role in the etiology and maintenance of disordered eating and eating disorders. Although the consequences of an appearance focused self-concept are palpable, less is known about its correlates. Accordingly, we examined a range of factors that may characterize appearance focused people, including personality traits (perfectionism, impulsivity, sensation-seeking, hopelessness, and anxiety sensitivity), self-concept (global self-esteem and self-concept clarity), sociocultural (thin-ideal, muscular-ideal, general attractiveness internalizations, and perceived pressure to be thin), and early life experiences (adverse childhood experiences, attachment styles) factors. METHODS: Female undergraduate university students (N = 568; Mage = 19.58, SDage = 4.24) completed a questionnaire battery that included the Beliefs About Appearance Scale, Depressive Experiences Questionnaire-Self-Criticism-6 Scale, Frost-Multidimensional Perfectionism Scale, the Revised Almost Perfect Scale, Substance Use Risk Profile Scale, Self-Concept Clarity Scale, Rosenberg Self-Esteem Scale, Sociocultural Attitudes Towards Appearance Questionnaire-4 Scale, Adverse Childhood Experiences Questionnaire, Experiences in Close Relationships Scale Short Form, and the Dietary Restraint subscale of the Eating Disorders Examination Questionnaire. RESULTS: Multiple regression analyses were conducted for each set of factors separately and together. For personality traits, perfectionism, impulsivity, and anxiety sensitivity were uniquely associated with appearance focused self-concept. For self-concept, global self-esteem and self-concept clarity were uniquely associated with appearance focused self-concept. For sociocultural, general attractiveness internalization, thin-ideal internalization, and perceived pressure to be thin were uniquely associated with appearance focused self-concept. For early life experiences, attachment anxiety and avoidance were uniquely associated with appearance focused self-concept. In the combined analysis, the various factors explained 54% of the variance in appearance focused self-concept. Impulsivity, global self-esteem, general attractiveness internalization, and perceived pressure to be thin were uniquely associated with appearance focused self-concept. CONCLUSIONS: Results for global self-esteem were consistent with prior research. Findings for evaluative concerns perfectionism were inconsistent with prior research. We discuss future research directions to examine the link between evaluative concerns perfectionism and appearance focused self-concept. We also discuss how sociocultural factors (general attractiveness internalization and perceived pressure to be thin) and impulsivity may help cultivate an appearance focused self-concept, advancing knowledge on the characteristics of appearance-focused people.

Player-Facing Casino Employees: Engagement with Responsible Gambling Programming and its Association with Referring Players.

This research explores the engagement of player-facing casino employees with GameSense, a responsible gambling (RG) program, and referral of players to GameSense. We surveyed 280 employees across three casinos in Massachusetts that use this RG program as part of their RG strategy. We found that although most player-facing casino employees were aware of GameSense, slightly over half visited a GameSense Information Center, and about two-thirds interacted with a GameSense Advisor. In terms of the reason for visiting, Latent Class Analysis (LCA) revealed three distinct classes: Comprehensive Interests, RG Interests, and Focused Interests. As for those who have yet to visit, LCA two classes emerged: RG Proficiency Beliefs and Tempered RG Proficiency Beliefs. Engaged employees were more likely to refer players to GameSense, highlighting the need for targeted approaches addressing the diverse interests of player-facing employees for engaging or not engaging with GameSense. These findings underscore the importance of have player-facing casino employees engage with RG programming, and targeted approached for engagement, to enhance the efficacy of RG initiatives, and contribute to a more robust RG framework within the gambling industry.

Co-occurring compulsive sexual behaviour in an inpatient substance use population: Clinical correlates and influence on treatment outcomes.

Background and Aims: Many individuals with substance use disorders (SUDs) present with co-occurring mental health disorders and other addictions, including behavioral addictions (BAs). Though several studies have investigated the relationship between SUDs and BAs, less research has focused specifically on compulsive sexual behaviour (CSB). Given that poly-addiction can hinder treatment outcomes, it is necessary to better understand the impact of co-occurring CSB and SUD. Therefore, the current study aimed to 1) determine the rate of CSB in a sample seeking treatment for SUDs, 2) identify demographic and clinical correlates of co-occurring CSB, and 3) to determine if co-occurring CSB impacts treatment outcomes for SUD. Methods: Participants were 793 adults (71.1% men) ranging in age from 18-77 (M = 38.73) at an inpatient treatment facility for SUDs who were assessed for CSB upon admission into treatment. Participants completed a battery of questionnaires upon admission and at discharge to assess psychological and addiction symptoms. Results: Rates of CSB were 24%. Younger age and being single were associated with greater CSB. Mental distress and addiction symptoms were higher in participants with CSB. Predictors of CSB severity included greater symptoms of traumatic stress and interpersonal dysfunction. Rates of treatment completion were similar between participants with and without CSB. Discussion and Conclusions: These results highlight several clinical and demographic correlates of CSB amongst individuals in treatment for SUD. However, CSB was not associated with poorer treatment outcomes. Further identifying characteristics associated with CSB can help clinicians identify individuals who may be at higher risk.

Trajectory of ghrelin and PYY around a test meal in males and females with avoidant/restrictive food intake disorder versus healthy controls.

Disruptions in appetite-regulating hormones may contribute to the development and/or maintenance of avoidant/restrictive food intake disorder (ARFID). No study has previously assessed fasting levels of orexigenic ghrelin or anorexigenic peptide YY (PYY), nor their trajectory in response to food intake among youth with ARFID across the weight spectrum. We measured fasting and postprandial (30, 60, 120 minutes post-meal) levels of ghrelin and PYY among 127 males and females with full and subthreshold ARFID (n = 95) and healthy controls (HC; n = 32). We used latent growth curve analyses to examine differences in the trajectories of ghrelin and PYY between ARFID and HC. Fasting levels of ghrelin did not differ in ARFID compared to HC. Among ARFID, ghrelin levels declined more gradually than among HC in the first hour post meal (p =.005), but continued to decline between 60 and 120 minutes post meal, whereas HC plateaued (p =.005). Fasting and PYY trajectory did not differ by group. Findings did not change after adjusting for BMI percentile (M(SD)ARFID = 37(35); M(SD)HC = 53(26); p =.006) or calories consumed during the test meal (M(SD)ARFID = 294(118); M(SD)HC = 384 (48); p <.001). These data highlight a distinct trajectory of ghrelin following a test meal in youth with ARFID. Future research should examine ghrelin dysfunction as an etiological or maintenance factor of ARFID.

Prospective 2-Year Course and Predictors of Outcome in Avoidant/Restrictive Food Intake Disorder.

OBJECTIVE: To evaluate the 2-year course and outcomes of full and subthreshold avoidant/restrictive food intake disorder (ARFID) in youth aged 9 to 23 years at baseline using a prospective longitudinal design to characterize the remission and persistence of ARFID, evaluate diagnostic crossover, and identify predictors of outcome. Greater severity in each ARFID profile-sensory sensitivity, fear of aversive consequences, and lack of interest-was hypothesized to predict greater likelihood of illness persistence, controlling for age, sex, body mass index percentile, ARFID treatment status, and baseline diagnosis. METHOD: Participants (N = 100; age range, 9-23 years; 49% female; 91% White) were followed over 2 years. The Pica, ARFID, and Rumination Disorder Interview was used across 3 time points (baseline, year 1, year 2) to measure the severity of each ARFID profile and evaluate illness persistence or remission, and the Eating Disorder Assessment for DSM-5 was used to evaluate diagnostic crossover. RESULTS: Across the 2-year follow-up period, half the participants persisted with their original diagnosis, and 3% of participants experienced a diagnostic shift to anorexia nervosa. Greater severity in the sensory sensitivity and lack of interest profiles was associated with higher likelihood of ARFID persistence at year 1 only; greater severity in the fear of aversive consequences profile was associated with higher likelihood of ARFID remission at year 2 only. CONCLUSION: Findings underscore the distinctiveness of ARFID from other eating disorders and emphasize its persistence over 2 years. Results also highlight the predictive validity and prognostic value of the ARFID profiles (ie, sensory sensitivity, fear of aversive consequences, lack of interest).

Momentary appearance focused self-concept is associated with dietary restraint and binge eating in female university students: An experience sampling study.

OBJECTIVE: Appearance focused self-concept (i.e., overvaluing the importance of appearance for self-definition and self-worth) is theorized to predict dietary restraint and binge eating in the short-term (e.g., daily life). Yet, no research has examined whether appearance focused self-concept increases within-persons during a day and if such increases are linked to greater dietary restraint and binge eating for that day. We addressed this gap in knowledge. METHOD: Sixty-three female university students completed four items from the Beliefs About Appearance Scale as a measure of appearance focused self-concept six times per day (9 am, 11 am, 1 pm, 3 pm, 5 pm, and 7 pm) for 14 days. Daily at 9 pm, they completed measures of dietary restraint and binge eating for that day. RESULTS: Analyzing data from 555 days, latent growth curve analyses revealed a small-to-moderate linear increase in appearance focused self-concept from 9 am to 3 pm that plateaued from 3 to 7 pm. A more rapid linear increase in appearance focused self-concept from 9 am to 3 pm was associated with greater binge-eating frequency during that day, but not with dietary restraint. The findings were observed when adjusting for between-day appearance focused self-concept at 9 am, which was positively associated with dietary restraint and binge-eating frequency. DISCUSSION: Findings are discussed in relation to research on appearance focused self-concept as a risk factor for disordered eating. Findings are also discussed in relation to how sociocultural factors may increase appearance focused self-concept over time. Future research should delve into the within-day dynamic interplay between appearance focused self-concept and disordered eating. PUBLIC SIGNIFICANCE: Our study revealed a noteworthy increase in the importance women attach to their appearance over the course of a day, correlating with increased binge eating during that day. Additionally, heightened appearance importance at the onset of a day was associated with more dietary restraint and binge eating during that day. These findings suggest a shorter timescale for the connection between appearance importance and disordered eating than previously understood.

Avoidant/restrictive food intake disorder differs from anorexia nervosa in delay discounting.

BACKGROUND: Avoidant/restrictive food intake disorder (ARFID) and anorexia nervosa (AN) are the two primary restrictive eating disorders; however, they are driven by differing motives for inadequate dietary intake. Despite overlap in restrictive eating behaviors and subsequent malnutrition, it remains unknown if ARFID and AN also share commonalities in their cognitive profiles, with cognitive alterations being a key identifier of AN. Discounting the present value of future outcomes with increasing delay to their expected receipt represents a core cognitive process guiding human decision-making. A hallmark cognitive characteristic of individuals with AN (vs. healthy controls [HC]) is reduced discounting of future outcomes, resulting in reduced impulsivity and higher likelihood of favoring delayed gratification. Whether individuals with ARFID display a similar reduction in delay discounting as those with AN (vs. an opposing bias towards increased delay discounting or no bias) is important in informing transdiagnostic versus disorder-specific cognitive characteristics and optimizing future intervention strategies. METHOD: To address this research question, 104 participants (ARFID: n = 57, AN: n = 28, HC: n = 19) completed a computerized Delay Discounting Task. Groups were compared by their delay discounting parameter (ln)k. RESULTS: Individuals with ARFID displayed a larger delay discounting parameter than those with AN, indicating steeper delay discounting (M ± SD = -6.10 ± 2.00 vs. -7.26 ± 1.73, p = 0.026 [age-adjusted], Hedges' g = 0.59), with no difference from HC (p = 0.514, Hedges' g = -0.35). CONCLUSION: Our findings provide a first indication of distinct cognitive profiles among the two primary restrictive eating disorders. The present results, together with future research spanning additional cognitive domains and including larger and more diverse samples of individuals with ARFID (vs. AN), will contribute to identifying maintenance mechanisms that are unique to each disorder as well as contribute to the optimization and tailoring of treatment strategies across the spectrum of restrictive eating disorders.

Avoidant/restrictive food intake disorder (ARFID) and anorexia nervosa (AN) are both restrictive eating disorders. However, the reasons for restricting food intake differ between the two diagnoses. A key question in further understanding similarities and differences between ARFID and AN is to understand whether individuals with these disorders process information and make decisions in similar or distinct ways. When humans decide between two different outcomes (e.g., a smaller immediate or a larger delayed reward), outcomes decrease in their value the farther in the future we expect to receive them (delay discounting). Individuals with AN exhibit a reduced discounting of future outcomes, which makes them more likely to forego immediate gratification for later rewards. However, whether this holds true for individuals with ARFID too (or whether they show the opposite or no bias) is unknown. Our investigation is the first to compare delay discounting between individuals with ARFID, AN, and healthy controls (HC). Our results show that individuals with ARFID show more delay discounting than those with AN, with no difference from HC. Knowing how rewards are being chosen and decisions made (and knowing differences between diagnoses) will be helpful in further optimizing and tailoring treatments for restrictive eating disorders.

A synthesis of evidence for policy from behavioural science during COVID-19.

Scientific evidence regularly guides policy decisions1, with behavioural science increasingly part of this process2. In April 2020, an influential paper3 proposed 19 policy recommendations ('claims') detailing how evidence from behavioural science could contribute to efforts to reduce impacts and end the COVID-19 pandemic. Here we assess 747 pandemic-related research articles that empirically investigated those claims. We report the scale of evidence and whether evidence supports them to indicate applicability for policymaking. Two independent teams, involving 72 reviewers, found evidence for 18 of 19 claims, with both teams finding evidence supporting 16 (89%) of those 18 claims. The strongest evidence supported claims that anticipated culture, polarization and misinformation would be associated with policy effectiveness. Claims suggesting trusted leaders and positive social norms increased adherence to behavioural interventions also had strong empirical support, as did appealing to social consensus or bipartisan agreement. Targeted language in messaging yielded mixed effects and there were no effects for highlighting individual benefits or protecting others. No available evidence existed to assess any distinct differences in effects between using the terms 'physical distancing' and 'social distancing'. Analysis of 463 papers containing data showed generally large samples; 418 involved human participants with a mean of 16,848 (median of 1,699). That statistical power underscored improved suitability of behavioural science research for informing policy decisions. Furthermore, by implementing a standardized approach to evidence selection and synthesis, we amplify broader implications for advancing scientific evidence in policy formulation and prioritization.

A 5-year longitudinal examination of the co-occurring patterns of gambling and other addictive behaviors.

OBJECTIVE: We examined the co-occurring patterns of problem gambling and substance/behavioral addiction severity over a five-year period and the predictors of the different co-occurring patterns of problem gambling and addiction severity. METHODS: We conducted a secondary analysis of the Quinte Longitudinal Study (QLS) data. The QLS is a 5-year prospective longitudinal study of gambling and problem gambling in the Quinte Region in Southern Ontario. The QLS consists of a total of 4,121 participants, including a sample of participants at risk of developing problem gambling. Severity of problem gambling, substance use, and behavioral addictions were used to examine their co-occurring patterns over time. Predictors of the co-occurring patterns included the presence of mental health disorders, personality, stress, happiness, lifesatisfaction, social support, family history, and demographics. RESULTS: Six co-occurring patterns of problem gambling and addiction severity were identified. The largest co-occurring pattern was characterized by concurrent decrease in gambling and other addictive behaviors. Several co-occurring patterns were characterized by moderate-to-severe problem gambling and other addiction severity that remained stable over time. No co-occurring pattern represented a decrease in gambling followed by increase in other addictive behaviors (e.g., addiction substitution). The presence of mental health disorders, stress, and lifesatisfaction significantly predicted the different co-occurring patterns. CONCLUSIONS: Taken together, the results suggest that in a non-clinical sample, gambling and other co-occurring addictive behaviors are likely to simultaneously decrease over time. Comorbidity of mental health disorders significantly influences co-occurring patterns of gambling and other addictive behaviors.

This time with feeling: In-play sports betting as a vehicle for emotion regulation.

OBJECTIVE: The purpose of this research was to assess factors (i.e., emotion regulation, impulsivity) that motivate in-play sports betting. Specifically, we examined whether individuals report increased excitement after placing an in-play bet and whether trait negative and positive urgency moderate the effect of emotion regulation motives on in-play betting frequency. METHOD: Three cross-sectional studies were conducted, each following a major sporting event: Superbowl LVI (56) (Study 1), March Madness Final (Study 2), and Union of European Football Associations Champions League Final (Study 3). Participants were U.S. (NStudy 1 = 111; NStudy 2 = 121) and U.K. (NStudy 3 = 239) residents who reported placing at least one in-play bet during the respective sporting events. Participants completed self-report measures of excitement, emotion regulation motives, in-play betting frequency, problem gambling, and trait affective impulsivity. Data from the three studies were pooled to conduct an integrative data analysis (IDA). RESULTS: Participants reported increased excitement after placing an in-play bet (p < .001). In bivariate analyses, greater emotion regulation motives were associated with greater in-play betting frequency (p < .05). In moderation analyses, emotion regulation motives interacted with trait negative (p < .001) and positive urgency (p < .001) to predict in-play betting frequency, such that the bivariate effects were amplified among those higher (relative to lower) in trait affective impulsivity. CONCLUSIONS: In-play sports betting is an exciting activity that people who gamble may engage in to regulate their emotions. These effects are amplified in those with high trait affective impulsivity. Responsible gambling tools such as mandatory play breaks may discourage the continuation of impulsive betting episodes. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

There is (still) a global factor that underlies the PGSI: A reanalysis of Tseng, Flack, Caudwell, and Stevens (2023).

Tseng, Flack, Caudwell, and Stevens (2023) conducted confirmatory factor analyses (CFA) of the Problem Gambling Severity Index (PGSI)-a gold-standard measure of disordered gambling symptomatology that has traditionally been indexed using a total score-with data from a large representative sample of Australians residing in Northern Territory who gamble (N = 3,740). Based on their results, Tseng et al. argued that a two-factor model best fit the data and so the PGSI items could be separated into two subscales: Problem Behaviours and Consequences of Problem Behaviours. We reanalyzed their data using CFA and found that a hierarchical model provided the best fit to the data. The hierarchical model includes a global factor underlying all PGSI items and two sub factors that correspond to the PGSI items assessing behaviours and consequences. The global factor was empirically well-defined, but the behaviours and consequences sub factors were not. Also, the two sub factors did not reliably measure the more narrowly defined behaviours and consequences constructs independent of the global factor. Based on our reanalyses of Tseng et al.'s (2023) data, we encourage researchers in the field of gambling studies to continue using the PGSI total score as an index of disordered gambling symptomatology.

Trajectories of depression and anxiety symptoms over time in the transition to university: Their co-occurrence and the role of self-critical perfectionism.

Little is known about how mental health symptoms develop during the transition to university. Most anxiety and depression research fails to consider how symptom development differs over time across different individuals, and how symptom co-occurrence influences the severity of mental health problems. Students (N = 658) completed online surveys on mental health prior to starting university and every 2 months until April. To better understand mental health problems during this transitional period, latent class growth curve analyses were run to determine how anxiety and depressive symptoms co-develop over time, as well, if self-critical perfectionism was a transdiagnostic risk factor for more severe symptom trajectories in this transition. About 40% of students experienced depression and anxiety symptoms prior to entering/during the transition to university. There is substantial variation between students in terms of how they experience depression and anxiety symptoms, and research needs to take this heterogeneity into account to properly identify which students might benefit most from resources. Self-critical perfectionism was a transdiagnostic risk factor, such that students higher in this trait experienced more severe anxiety and depressive symptom trajectories during this transition. This research further implicates the importance of understanding and studying individual differences in symptom development.

Advancing the Pathways Model: Financially Focused Self-concept and Erroneous Beliefs as Core Psychopathologies in Disordered Gambling.

In the Pathways Model, there are three distinct etiological subtypes of disordered gambling (Behaviourally Conditioned, Emotionally Vulnerable, and Anti-Social Impulsive Risk-Taker). The Pathways Model also posits that erroneous gambling beliefs are a maintenance factor of disordered gambling across the subtypes. Yet, etiological factors and erroneous beliefs have largely been examined separately when determining disordered gambling subtype. Moreover, there may be heretofore unexamined maintenance factors that span the disordered gambling subtypes. In the current research, we addressed this gap by using latent profile analyses to assess the role both erroneous beliefs and financially focused self-concept (a novel maintenance factor) play in the determination of disordered gambling subtype. In Study 1, community members with gambling problems (n = 215) completed the Gambling Pathways Questionnaire and Financially Focused Self-Concept Scale. In Study 2 (n = 290), participants also completed the Gambling Beliefs Questionnaire. Results from both studies revealed three profiles that coincide with the subtypes in the Pathways Model as providing the best fit to the data. The three profiles were largely distinguished by low, medium, or high scores on the etiological factors, which is consistent with the disordered gambling subtypes being on different parts of the same continuum of psychopathology severity. Financial focus (Studies 1 and 2) and erroneous gambling beliefs (Study 2) were elevated across the three profiles, and both were higher among profiles with more severe psychopathology. Findings support a dimensional understanding of gambling disorder psychopathology and suggest that a financially focused self-concept may be a maintenance factor of disordered gambling.

Understanding Lower-Risk Cannabis Consumption from the Consumers' Perspective: A Rapid Evidence Assessment.

Background: In the current rapid evidence assessment, we summarize the existing research on lower-risk cannabis consumption as understood by those who consume cannabis. Methods: We identified 7111 unique articles published between 1900 and 2021 using search terms related to a) cannabis consumption, b) beliefs and behaviors, and c) positive outcomes. Results: Twelve articles met our inclusion criteria. Three themes emerged that reflect lower-risk cannabis beliefs and behaviors (informed self-regulation, protective behavioral strategies, and the normalization of cannabis consumption) and one theme reflected motivations that undermine lower-risk cannabis consumption (e.g., using cannabis to cope). Conclusions: Results suggest a need for targeted lower-risk cannabis consumption research-research focused on how those who consume cannabis do so in a positive, non-problematic manner. Such research would help to inform policy and practice and, ultimately, help promote lower-risk cannabis consumption strategies.

Connecting a health-focused self-concept with orthorexia nervosa symptoms via fear of losing control over eating unhealthy food and disgust for unhealthy food.

PURPOSE: Orthorexia nervosa (ON) involves a maladaptive preoccupation with healthy eating through strict dietary rules that negatively affect physical and mental health. Recent evidence suggests that ON symptoms may stem, in part, from having a health-focused self-concept (i.e., overvaluing the importance of health for self-definition and self-worth). Herein, fear of losing control over eating unhealthy foods and disgust for unhealthy foods were examined as potential mediators of the association between health-focused self-concept and ON symptoms. METHODS: The parallel mediation model was tested using a community sample of people who believe they are currently following a healthy eating diet plan and/or believe they are leading a healthy eating lifestyle (N = 442). Participants were recruited from Amazon's Mechanical Turk and completed a questionnaire battery that included the Health-Focused Self-Concept Scale, questionnaires assessing fear of losing control over eating unhealthy food and disgust with unhealthy food, and the Orthorexia Nervosa Inventory. RESULTS: As expected, a health-focused self-concept was indirectly and positively associated with ON symptoms via fear and disgust. CONCLUSION: The findings conceptually replicate and extend prior research on anorexia nervosa supporting the transdiagnostic utility of a focused self-concept, fear of losing control, and disgust across eating disorders. LEVEL OF EVIDENCE: Level V, cross-sectional descriptive study.

A p-curve analysis of the emotional Stroop effect among women with eating disorders.

OBJECTIVE: A recent meta-review of attentional bias research in eating disorders suggests that meta-analyses and systematic reviews include many low-quality and underpowered studies (Stott et al., 2021). As such, we examined whether published research examining the link between attentional bias, using the emotional Stroop task, and eating disorders among women with eating disorders has evidential value (ruling out selective reporting of a statistically significant effect) using a p-curve analysis. A p-curve analysis plots statisticall significant p-values onto a curve from .01 to .05 to examine its distribution. We hypothesized that the p-curve would be flat, indicating no true effect. METHOD: The hypothesis, database search strategy, and data analytic approach were pre-registered. The inclusion criteria were reports that compared control and eating disorder groups, reported inferential statistics, and that used body shape/weight or general threat target words. RESULTS: Fifty published reports were included in the p-curve analyses. Unexpectedly, the half and full p-curves were significantly right-skewed, indicating evidential value. However, the results were not robust to the exclusion of the seven lowest p-values and on average, reports were underpowered. There were also 18 reports with null results (they had a p-value greater than .05), which precluded their inclusion in the p-curve analyses. DISCUSSION: The findings suggest that most of the evidence from research examining attentional biases using the emotional Stroop task among women with an eating disorder or with elevated eating disorder symptoms is underpowered and so should be interpreted with considerable caution. PUBLIC SIGNIFICANCE: Concerns have been raised about the low quality of research examining attentional biases among women with eating disorders using the emotional Stroop task. In the current research, we observed that the evidential value of primary research reporting differences between women with and without eating disorders was equivocal and had low statistical power. These results can guide researchers towards conducting more rigorous research on attentional biases among people with eating disorders.

OBJETIVO: Una meta-revisión reciente de la investigación del sesgo atencional en los trastornos de la conducta alimentaria sugiere que los metaanálisis y las revisiones sistemáticas incluyen muchos estudios de baja calidad y con poco poder estadístico (Stott et al., 2021). Como tal, examinamos si la investigación publicada que examina el vínculo entre el sesgo atencional, el uso de la tarea de Stroop emocional y los trastornos de la conducta alimentaria entre mujeres con trastornos alimentarios tiene valor de evidencia (descartando el informe selectivo de un efecto estadísticamente significativo) mediante un análisis de curva-p. Un análisis de curva-p traza p valores significativos en una curva de .01 a .05 para examinar su distribución. Planteamos la hipótesis de que la curva-p sería plana, lo que indica que no hay un efecto verdadero. MÉTODO: La hipótesis, la estrategia de búsqueda en la base de datos y el enfoque analítico de datos fueron pre-registrados. Los criterios de inclusión fueron informes que compararon grupos control y de trastornos de la conducta alimentaria, informaron estadísticas inferenciales y que utilizaron palabras clave de figura/peso corporal o de amenaza general. RESULTADOS: Cincuenta estudios publicados fueron incluidos en los análisis de la curva-p. Inesperadamente, las curvas-p medias y completas estaban significativamente sesgadas a la derecha, lo que indica un valor de evidencia. Sin embargo, los resultados no fueron robustos para la exclusión de los siete p valores más bajos y, en promedio, los reportes tuvieron poca potencia. También hubo 18 reportes con resultados nulos (tenían un p valor mayor que .05), lo que impidió su inclusión en los análisis de la curva-p. DISCUSIÓN: Los hallazgos sugieren que la mayor parte de la evidencia de la investigación que examina los sesgos atencionales utilizando la tarea de Stroop emocional entre las mujeres con un trastorno de la conducta alimentaria o con síntomas elevados del trastorno alimentario tiene poco poder y, por lo tanto, debe interpretarse con mucha precaución.

The association of perfectionism, health-focused self-concept, and erroneous beliefs with orthorexia nervosa symptoms: A moderated mediation model.

OBJECTIVE: Orthorexia nervosa (ON) is a putative eating disorder linked to perfectionism among people who eat healthily (or who want to eat healthily). However, little is known about the process by which perfectionism fosters ON symptoms. Like the Transdiagnostic Cognitive-Behavioral Theory of Eating Disorders, we hypothesized that perfectionism among people who eat healthily (or who want to eat healthily) fosters ON symptoms indirectly by cultivating a health-focused self-concept (i.e., placing overriding importance on health for self-definition and self-worth). We also hypothesized that a health-focused self-concept would be associated with ON symptoms among people who have erroneous beliefs about the safety and efficacy of maladaptive healthy eating strategies. METHOD: To test this moderated mediation model, a sample of people following a healthy eating diet plan and/or who believe they are leading a healthy eating lifestyle (N = 456) were recruited from Amazon's Mechanical Turk and completed measures that assessed perfectionism, health-focused self-concept, ON symptoms, and erroneous beliefs about the safety and efficacy of maladaptive healthy eating strategies. They also completed a measure of appearance-focused self-concept. RESULTS: Health-focused and appearance-focused self-concepts were empirically distinct. As expected, perfectionism was indirectly and positively associated with ON symptoms via a health-focused self-concept. Importantly, the indirect association was only observed among participants high, but not low, in erroneous beliefs. DISCUSSION: The findings support the role of perfectionism in ON. The findings also advance knowledge by identifying a health-focused self-concept and erroneous beliefs as potential factors in the etiology and maintenance of ON.

Mental Health Over Time and Financial Concerns Predict Change in Online Gambling During COVID-19.

This study examined online gambling behavior during COVID-19 land-based gambling restrictions and associations with changes in mental health, impacts on household income due to the pandemic, financially focused motivations, and symptoms of gambling problems. A repeated online survey was administered to adult gamblers in Ontario, Canada. Wave 1 was conducted at the beginning of the first COVID-19 lockdown (April 2020) and wave 2 in August 2020. Respondents (N = 940) completed validated self-report questionnaires related to depression and anxiety, financial motivation, financial impacts due to the pandemic, online gambling behaviors, and problem gambling symptomatology. A cluster analysis identified three subgroups: no online gambling (subgroup 1), engagement in a range of gambling games online and change in gambling involvement (i.e., some increased and some decreased gambling; subgroup 2), and predominantly online lottery play with no change in online gambling (subgroup 3). Respondents who reported increased anxiety and depression symptom severity between the two waves and those who experienced greater symptoms of problem gambling and negative impacts on household income due to COVID-19 were most likely to be found in subgroup 2. Greater financial focus was also noted in this group. Results indicate a link between change in online gambling involvement during COVID-19 and increased mental health problems, elevated problem gambling severity, negative impacts on household income, and a greater financially focused self-concept. These results may help generate novel research questions examining short and long-term effects of the pandemic on online behaviors that inform policy and practice.