The role of rumination and positive beliefs about rumination in eating pathology.

PURPOSE: General and eating disorder (ED)-specific ruminations have been identified as key factors that may contribute to eating pathology. Positive beliefs about rumination (e.g., "Ruminating helps me to prevent future mistakes") may impact this association. However, the effect of positive beliefs about rumination on the links between rumination and ED symptom severity has not been investigated. This study sought to clarify relations between rumination and ED symptom severity and to evaluate the potential moderating effect of positive beliefs about rumination on these associations. METHODS: During a laboratory visit, undergraduate participants (N = 473, MAge = 18.90 ± 2.27, MBMI = 23.45 kg/m2 ± 4.31, 54.8% female) completed an online battery of questionnaires assessing general and ED-specific ruminative processes (e.g., brooding, reflection), positive beliefs about rumination, and global ED symptoms. Hierarchical multiple regression analyses assessed the unique contributions of specific ruminative processes, and the moderating effect of positive beliefs on associations between ruminative processes and ED symptom severity. RESULTS: Hierarchical multiple regression results suggest that, after controlling for gender and BMI, ED-specific brooding, b = 1.32, SE = 0.13, ß = 0.46, p < 0.0001, and reflection, b = 1.44, SE = 0.33, ß = 0.19, p < 0.0001, accounted for unique variance in ED symptom severity. Moderation model results indicate that, at low levels of general reflection, b = - 0.06, SE = 0.02, ß = - 0.51, p = 0.003, and ED-specific reflection, b = - 0.15, SE = 0.03, ß = - 0.59, p < 0.0001, increased positive beliefs about rumination were associated with greater ED symptom severity. CONCLUSION: Findings suggest ED-specific rumination accounts for ED symptom severity above and beyond general rumination, and that rumination-related expectancies influence the association between reflection and ED symptom severity. LEVEL OF EVIDENCE: Level III, evidence obtained from a well-designed cohort study.

Exploring the contributions of affective constructs and interoceptive awareness to feeling fat.

PURPOSE: Feeling fat, a subjective feeling of being overweight that does not always correspond to actual body weight, is commonly reported in patients with an eating disorder. Research suggests that feeling fat relates to deficits in interoceptive awareness, the perception and integration of signals related to body states. Relatedly, recent work has linked feeling fat to affective constructs, such as depressive symptoms and guilt. The current study explores the unique relationships between feeling fat, self-reported, and objective IA, guilt, alexithymia, and depressive symptoms. METHOD: Female undergraduates (N = 128) completed the 11th item of the Eating Disorder Examination Questionnaire, the Toronto Alexithymia Scale, the Guilt subscale of the Positive and Negative Affect Schedule, and the Beck Depression Inventory-II. Participants also completed two IA measures: a heartbeat perception task and the Multidimensional Assessment of Interoceptive Awareness. RESULTS: All collected measures explained 56% of the variability in feeling fat. Depressive symptoms, self-reported IA, and BMI accounted for significant variability in feeling fat. Relative weights analyses revealed that depressive symptoms accounted for the most variability in feeling fat (19%). This finding remained significant after controlling for BMI, which also accounted for significant variability in feeling fat (25%). CONCLUSIONS: Our results replicate previous findings that depressive symptoms relate significantly to feeling fat and extend this work by incorporating the role of interoceptive awareness, guilt, and alexithymia. Endorsement of feeling fat during an intake assessment may alert clinicians to assess for depressive symptoms, and focusing on depressive symptoms in treatment may improve feeling fat. LEVEL OF EVIDENCE: Level I Evidence obtained from an experimental study.

Vegetarians and omnivores with diagnosed eating disorders exhibit no difference in symptomology: a retrospective clinical chart review.

PURPOSE: Past work suggests that vegetarianism is common in patients diagnosed with eating disorders (EDs), but the exact nature of this association is unclear, with reports conflicting as to whether vegetarianism is a risk factor for EDs, complicates ED treatment, or is wholly innocuous. Since vegetarianism has been on the rise, the need for current data on possible links with EDs is substantial. METHODS: We collected data on demographics, vegetarian status, ED diagnosis, current body mass index (BMI), highest and lowest BMI, Eating Attitudes Test, and Multifactorial Assessment of Eating Disorders Symptoms scores at intake in 124 patients (84.7% women, 90.3% white, Mage = 23.92 ± 9.16 years) admitted to an intensive outpatient ED program. RESULTS: We first compared omnivores (n = 72, 58.1%), meat-reducers (n = 27, 21.8%), vegetarians (n = 20, 16.1%), and vegans (n = 5, 4.0%) and found no significant differences in any demographic or outcome variable, with the exception that vegetarians reported significantly lower highest-ever BMI compared to meat-reducers (p = 0.03). To mirror past chart reviews, we then compared the combined groups of meat avoiders (n = 52, 41.9%) to the omnivores (n = 72, 58.1%) and found no significant differences in demographics or ED symptoms (all ps > 0.05). CONCLUSION: Overall, data support that meat restriction does not imply greater ED severity. LEVEL OF EVIDENCE: Level V, descriptive study, retrospective chart review.

Female Athlete Body Project Intervention with Professional Dancers: A Pilot Trial.

As aesthetic athletes, professional dancers have increased vulnerability for eating disorders (EDs), with three times higher risk than non-dancers. Among ballet dancers, generalized risk for EDs associated with internalization of western cultural female beauty ideals is compounded by idealization of a ballet-specific body ideal, a combination that confers unique vulnerability for eating pathology. Empirical support has been established for an athlete-specific intervention promoting body acceptance and reduced eating pathology among general populations of young-adult women and female collegiate athletes; the current study adapted this intervention for pilot implementation among professional ballet dancers. Participants from two elite ballet companies (N = 19) were randomized to a control and intervention condition. All participants self-reported eating pathology and related variables pre- and post-intervention, and at six-week follow-up. Post-intervention, participants receiving the intervention demonstrated reductions in body dissatisfaction, p = .005, r = -.63, dietary restraint, p = .008, r = -.59, and eating pathology, p = .007, r = -.60, as compared to control group counterparts; significant differences were retained at follow-up. Results provide preliminary evidence that this intervention has the potential to provide a feasible and acceptable means of ED prevention in female professional ballet dancers. Barriers to feasibility are identified and discussed.

Rapid response is predictive of treatment outcomes in a transdiagnostic intensive outpatient eating disorder sample: a replication of prior research in a real-world setting.

OBJECTIVE: There is a growing call to identify specific outcome predictors in real-world eating disorder (ED) treatment settings. Studies have implicated several ED treatment outcome predictors [rapid response (RR), weight suppression, illness duration, ED diagnosis, and psychiatric comorbidity] in inpatient settings or randomized controlled trials of individual outpatient therapy. However, research has not yet examined outcome predictors in intensive outpatient programs (IOP). The current study aimed to replicate findings from randomized controlled research trials and inpatient samples, identifying treatment outcome predictors in a transdiagnostic ED IOP sample. METHOD: The current sample comprised 210 consecutive unique IOP patient admissions who received evidence-based ED treatment, M(SD)Duration = 15.82 (13.38) weeks. Weekly patient measures of ED symptoms and global functioning were obtained from patients' medical charts. RESULTS: In relative weight analysis, RR was the only significant predictor of ED symptoms post treatment, uniquely accounting for 45.6% of the predicted variance in ED symptoms. In contrast, baseline ED pathology was the strongest unique predictor of end-of-treatment global functioning, accounting for 15.89% of predicted variance. Baseline factors did not differentiate patients who made RR from those who did not. CONCLUSIONS: Consistent with findings in more controlled treatment settings, RR remains a robust predictor of outcome for patients receiving IOP-level treatment for EDs. Future work should evaluate factors that mediate and moderate RR, incorporating these findings into ED treatment design and implementation. LEVEL OF EVIDENCE: Level IV, uncontrolled intervention.

Eating disorder pathology and compulsive exercise during the COVID-19 public health emergency: Examining risk associated with COVID-19 anxiety and intolerance of uncertainty.

OBJECTIVE: COVID-19 has led to disruptions in daily living and increased uncertainty about physical, financial, social, and psychological consequences, which may contribute to anxiety, eating disorder (ED) pathology, and compulsive exercise. Individual factors, such as intolerance of uncertainty, may impact risk for ED pathology and CE in response to COVID-19 anxiety. The current study examined associations between COVID-19 anxiety, trait intolerance of uncertainty, and COVID-19 intolerance of uncertainty and ED pathology and compulsive exercise. METHOD: Undergraduate participants (N = 295) completed a series of online questionnaires between March and April of 2020. RESULTS: COVID-19 anxiety and intolerance of uncertainty were associated with ED pathology, but not compulsive exercise. Additionally, both trait and COVID-19 intolerance of uncertainty moderated associations between COVID-19 anxiety and compulsive exercise and ED pathology. COVID-19 anxiety was more strongly related to compulsive exercise and ED pathology for individuals with lower intolerance of uncertainty. DISCUSSION: COVID-19 anxiety may increase risk for ED pathology and may be specifically important in determining risk for ED pathology and compulsive exercise among individuals with lower intolerance of uncertainty. These results contribute to a growing body of research aimed at understanding the mental health consequences of the COVID-19 and suggest that individual factors (e.g., anxiety and intolerance of uncertainty) are important in determining risk for ED pathology and compulsive exercise in the context of the pandemic.

Expectancies about the Effects of Cannabis Use on Eating Disorder Symptoms.

Background: Substance use, specifically cannabis use, is common among individuals with eating disorder (ED) symptoms; however, few studies have specifically explored the relation between EDs and cannabis use. Purpose: The present study examined expectancies about the impact of cannabis on cognitive, affective and behavioral ED symptoms. Additionally, this study explored associations between cannabis-related expectancies, cannabis use and cannabis-related problems. Methods: Cannabis users with ED symptoms (N = 137) reported on frequency of cannabis use, cannabis-related problems and expectancies about the impact of cannabis on ED symptoms, Results: Participants expected cannabis to decrease restrictive eating, compensatory behaviors, and preoccupation with body shape and weight and fear of eating and weight gain. In contrast, cannabis was expected to increase binge-eating behaviors. Expectancies about the impact of cannabis use on ED symptoms were not associated with more frequent cannabis use nor were they associated with cannabis-related problems. Conclusions: These findings suggest that individuals believe cannabis will improve some ED symptoms; however, these expected improvements are not associated with increased cannabis use and problems. Future research should examine cannabis expectancies in clinical populations and should further explore the association between cannabis expectancies, use, and ED symptoms longitudinally.

Gender-based differential item functioning in measures of eating pathology.

OBJECTIVE: Eating disorder (ED) symptoms are common and impairing in males, despite their perception as "female" disorders. As existing self-report symptom measures were developed and primarily validated in women, there is a need to establish the utility of these measures in men. The present study used differential item functioning (DIF) analyses to explore whether item endorsement differed by gender for three commonly used ED symptom measures. METHOD: Participants were undergraduate men (n = 1,083) and women (n = 2,424) from three universities in the United States. Global scores on the Eating Attitudes Test-26 (EAT-26), Eating Disorder Examination Questionnaire (EDEQ), and Eating Disorder Diagnostic Scale for DSM-IV (EDDS) were examined. Tests of DIF were conducted by regressing each item against its composite scale score, and then comparing fit and variance explained (R2 ) to a model with the interaction of item*gender. The clinical significance threshold for DIF is ΔR2 ≥ 0.13. RESULTS: There was no evidence of clinically significant DIF within the EAT-26, EDEQ, or EDDS. DISCUSSION: Findings suggest that the examined measures perform similarly for undergraduate men and women, supporting their use in nonclinical male samples. However, development and testing of items reflecting ED symptoms that more commonly occur in males (e.g., muscularity-oriented behaviors) is encouraged.

Gender differences in relations between alcohol-related compensatory behavior and eating pathology.

PURPOSE: Concerns about caloric intake associated with alcohol use (e.g., fear of weight gain) are positively associated with compensatory eating behaviors (e.g., caloric restriction, self-induced vomiting), a phenomenon that has been identified across gender. Specific motivations for compensatory behaviors differ; some relate to eating disorder (ED) pathology (e.g., shape and weight concerns), and others to alcohol (e.g., enhancing effects). Research examining motivations for alcohol-related compensatory behaviors in men is limited to date. The current study sought to assess how specific types of alcohol-related compensatory behaviors and their association with ED pathology present differently by gender. METHODS: Undergraduates (N = 530, 48% female) completed the Compensatory Eating Behaviors in Response to Alcohol Consumption Scale (CEBRACS), Eating Disorders Diagnostic Scale (EDDS), and reported height, weight, and frequency and quantity of alcohol consumption. Data were examined using linear regression, and relations between CEBRACS behaviors and eating pathology were compared across gender. RESULTS: Factors that were positively associated with EDDS scores for both men and women included alcohol-related dietary restraint, and exercise. For women, but not men, alcohol-related bulimic behavior also contributed to elevations in EDDS scores. CONCLUSIONS: Findings indicate that specific types of alcohol-related compensatory eating behaviors (i.e., dietary restraint and exercise) are positively related to ED pathology for both male and female participants. In contrast, bulimic behaviors' association with ED pathology is gender specific. Understanding gender differences in alcohol-related compensatory behaviors and ED risk may inform gender-specific intervention targets. LEVEL OF EVIDENCE: Cross-sectional descriptive study, Level V.

Comparing internalization of appearance ideals and appearance-related pressures among women from the United States, Italy, England, and Australia.

Researchers have observed variation in levels of body image disturbance and eating pathology among women from different Western countries. Examination of cross-cultural differences in the established risk factors (i.e., thin-ideal internalization, muscular-ideal internalization, and appearance pressures from family, peers, and media) for negative outcomes may help to elucidate the prominence of specific risk factors within a given Western society and guide associated interventions. Women from the United States (US), Italy, England, and Australia completed the Sociocultural Attitudes Towards Appearance Questionnaire-4 (SATAQ-4). Analysis of covariance controlling for age and BMI indicated significant cross-country differences for all SATAQ-4 subscales. Results typically indicated higher levels of appearance-ideal internalization and appearance pressures in the US and lower levels in Italy; however, associated effect sizes were generally small. A medium effect of country was observed for peer-appearance pressures, which were highest in the US compared with all other countries. Repeated-measures analysis of variance and paired samples t tests conducted within each country identified thin-ideal internalization and media appearance pressures as the predominant risk factors for all four countries. Overall, findings suggest more cross-country similarities than differences, and highlight the importance of delivering interventions to address thin-ideal internalization and media appearance pressures among women from Western backgrounds.Level of evidence Descriptive study, Level V.

Identifying a male clinical cutoff on the Eating Disorder Examination-Questionnaire (EDE-Q).

OBJECTIVE: Evidence suggests that eating disorders (EDs) may be under-detected in males. Commonly used measures of EDs such as the Eating Disorder Examination-Questionnaire (EDE-Q) were initially developed within female samples, raising concern regarding the extent to which these instruments may be appropriate for detecting EDs in males. The current study used receiver operating characteristic curve analysis to (a) examine the accuracy of the EDE-Q global score in correctly classifying males with and without clinically significant ED pathology, and (b) establish the optimal EDE-Q global clinical cutoff for males. METHOD: Participants were a clinical sample of 245 male ED patients and a control sample of 205 male undergraduates. RESULTS: Eating Disorder Examination-Questionnaire global scores demonstrated moderate-high accuracy in predicting ED status (area under the curve = 0.85, 95% CI: 0.82-0.89). The optimal cutoff of 1.68 yielded a sensitivity of 0.77 and specificity of 0.77. DISCUSSION: Overall, results provide preliminary support for the discriminant validity of EDE-Q scores among males. However, concerns remain regarding the measure's ability to comprehensively assess domains of disordered eating most relevant to males. Therefore, careful attention to the possibility for measurement bias and continued evaluation of the scale in males is encouraged.

Evaluating Associations Between Perfectionism, Emotion Regulation, and Eating Disorder Symptoms in a Mixed-Gender Sample.

Prior research supports maladaptive perfectionism as a risk factor for eating disorders; however, not all individuals with elevated levels of perfectionism endorse eating pathology, suggesting additional variables may interact with perfectionism to account for this association. The current study examined the influence of difficulties in emotion regulation on the relation between perfectionism and eating disorders. Undergraduate students (N = 309, 50.7% male) from a large university completed measures of perfectionism, emotion dysregulation, and eating pathology. The results indicated that high levels of perfectionism only accounted for significant variance in eating disorder symptoms among individuals with limited access to adaptive strategies to regulate emotions, but not among those with greater access to adaptive strategies. Findings demonstrate that clinicians and researchers should consider the role of emotion regulation among individuals with elevated levels of perfectionism and eating pathology. Future research should prospectively evaluate these associations and examine mechanisms that may further elucidate these relations.

Associations among fear, disgust, and eating pathology in undergraduate men and women.

Fear and disgust are distinct emotions that have been independently linked with EDs and may motivate avoidance behaviors that may be relevant targets for ED interventions (e.g., food rejection). Despite similar motivational function, it is possible that one emotion is more strongly associated with ED symptoms, relative to the other. Given that emerging evidence suggests that disgust-based behavior may be more difficult to change than fear-based behaviors, research is needed to evaluate whether each emotion differentially relates to ED symptoms. Therefore, the current study tested the relative importance of fear and disgust in accounting for variance in ED symptoms. Participants included undergraduate men (n = 127) and women (n = 263) from a university in the northeast US. Participants completed self-report measures assessing demographics, disordered eating attitudes and behaviors, and visual analog scales assessing fear and disgust responses to high-calorie food images, low-calorie food images, and non-food fear and disgust images. Bivariate correlations revealed significant positive associations among fear, disgust, and EDE-Q global symptom scores. Relative weights analysis results yielded relative importance weights that suggested disgust responding to high calorie food images accounts for the greatest total variance in EDE-Q global symptom scores in men, and fear responding to high calorie food images accounts for the greatest total variance in EDE-Q scores in women. Findings provide initial evidence that investigative and clinical efforts should consider fear and disgust as unique facets of negative affect with different patterns of relative importance to ED symptoms in undergraduate men and women.

Evaluation of the contribution of values clarification to a brief mindfulness meditation intervention for anxiety.

OBJECTIVE: Evaluate the incremental effects of a computerized values clarification (VC) activity on anxiety symptomology and quality of life over and above establishment of a mindfulness meditation (MM) practice. METHOD: Anxious participants (N = 120, Female = 86; Mage  = 22.26) were randomly assigned to a 2-week, 10-min daily MM practice + control task or a 2-week, 10-min daily MM practice + VC task. Pre-assessments and post-assessments included well-established and ideographic self-report measures. RESULTS: Overall decreases in past week and past 24-h anxiety symptom frequency, as well as increased quality of life during the previous 24-h cycle only. VC did not have a demonstrable impact on outcomes. CONCLUSIONS: Though findings are preliminary, brief VC exercises may not enhance outcomes that follow from mindfulness practice. Additional research is needed to isolate specific and shared impacts of mindfulness-based and values-based treatment strategies on anxiety symptoms and quality of life.

Expanding exposure-based interventions for eating disorders.

Initial trials evaluating exposure-based interventions for eating disorders (EDs) in the 1980s demonstrated mixed results. Since that time, innovations in exposure therapy for anxiety disorders have yielded insights that can be used to refine and expand the approach to effectively target ED behaviors. This article provides a brief summary of relevant advances in exposure therapy for anxiety and outlines how these advances may be adapted and evaluated for use with ED samples. More specifically, we propose shifting to an inhibitory learning framework, considering treatment targets other than fear, and increasing variability in exposure techniques represent three important areas for future study. Overall, this article aims to provide professionals in the field with a framework for how to incorporate cutting-edge advances in exposure therapy into rigorous intervention research for EDs.

Contributions of mindful eating, intuitive eating, and restraint to BMI, disordered eating, and meal consumption in college students.

PURPOSE: Mindful eating and intuitive eating are promoted as means to circumvent potentially maladaptive dietary restraint while maintaining a healthy weight. Although theoretically related, no studies have examined the correlations between intuitive eating, mindful eating, and restraint in the same sample. This study sought to examine these constructs and their correlations with body mass index (BMI), eating-disordered behaviors, and meal consumption in a college sample. METHODS: Participants (N = 125) completed a laboratory taste-test meal and measures of each eating-related construct using the EDDS, IES, MEQ, and TFEQ-Restraint Subscale. RESULTS: Mindful eating, intuitive eating, and restraint were not strongly correlated. Hierarchical multiple regression analyses indicated that restraint and intuitive eating accounted for significant variance in disordered eating and BMI. Elevated restraint was associated with increased BMI and disordered eating; elevated intuitive eating was associated with decreased BMI and disordered eating. Mindful eating did not correlate with any outcome variables. Follow-up analyses suggested that specific intuitive eating subscales accounted for unique variance in the relation between intuitive eating and disordered eating. Intuitive eating was the only construct that was significantly associated with meal consumption. CONCLUSIONS: Intuitive eating and restraint appear to be only weakly correlated, and each is differentially associated with meal consumption. Mindful eating does not appear to relate to outcome variables.

A pilot study of maudsley family therapy with group dialectical behavior therapy skills training in an intensive outpatient program for adolescent eating disorders.

OBJECTIVE: The goal of this study was to provide pilot clinical data on the effectiveness of an intensive outpatient treatment model for adolescent eating disorders that combines Maudsley-based family therapy and group dialectical behavior therapy skills training. METHOD: Measures of physical and psychological status were gathered upon admission, discharge, and at 3 follow-up intervals. RESULTS: Adolescents who completed the program gained a significant amount of weight and experienced a significant decrease in eating disorder psychopathology. At the 1-year follow-up, 64% of adolescents were weight restored and menstruating normally. Measures of eating disorder psychopathology continued to improve up to a year after treatment. CONCLUSIONS: This pilot, multimodal program warrants further investigation and may be an effective intermediate level of care treatment option for adolescent eating disorders.

Quantification of carpal tunnel morphology using centroid-to-boundary distance shape signatures.

Morphology analysis is valuable to understanding risk factors and the etiology of carpal tunnel (CT) syndrome. The objective of this study was to investigate morphology changes along the length of the CT using shape signatures (SS). Analysis was performed on ten cadaveric specimens in neutral wrist posture. Centroid-to-boundary distance SS were generated for proximal, middle, and distal CT cross-sections. Phase shift and Euclidean distance were quantified relative to a template SS for each specimen. Medial, lateral, palmar, and dorsal peaks were identified on each SS to generate metrics of tunnel width, tunnel depth, peak amplitude, peak angle. Width and depth measures were also performed using previously reported methods to serve as a basis of comparison. The phase shift revealed twisting of 21° between the ends of the tunnel. Distance from the template and width varied significantly over the length of the tunnel, while depth did not. Measures of width and depth using the SS method were consistent with previously reported methods. The SS method afforded the advantage of peak analysis with overall trends of peak amplitude indicating flattening of the tunnel at the proximal and distal ends relative to a rounder shape in the middle.

The impact of social media use on body image and disordered eating behaviors: Content matters more than duration of exposure.

Social media use is rapidly expanding in terms of frequency, duration, and the diversity of platforms available. Given evidence for associations between social media use, body image disturbances, and disordered eating it is important to identify potentially harmful aspects of social media use that could serve as intervention targets. This study surveyed two demographically diverse undergraduate student cohorts in 2015 and 2022 to compare patterns in social media use, body image, and disordered eating behaviors between samples, including as a function of the COVID-19 pandemic, and to test the hypothesized moderating role of specific content consumed in the association between social media use and maladaptive outcomes. Participants in 2022 reported greater body image disturbances, more frequent vomiting and laxative use, and more time spent on a greater number of social media accounts, with significantly greater use of image-based platforms such as Snapchat, TikTok, and YouTube. Moderated regression analyses suggest that type of content consumed, but not the amount of time spent on social media or diversity of platforms utilized, is associated with body image disturbances and disordered eating behaviors after controlling for gender and body mass index. Specifically, exposure to weight loss content was associated with lower body appreciation, greater fears of negative appearance evaluation, and more frequent binge eating. Contrary to initial hypotheses, exposure to body positivity/neutrality content did not have protective effects. Findings suggest that interventions targeting negative consequences of social media use should focus on addressing content consumed, rather than time spent on social media platforms.

Carpal tunnel volume distribution and morphology changes with flexion-extension and radial-ulnar deviation wrist postures.

Non-neutral wrist postures have been reported to cause decreased carpal tunnel volume (CTV) contributing to impingement of the median nerve and development of carpal tunnel syndrome. Recent analysis found CTV did not change with ±20° flexion-extension (FE), however, CTV decreased with ulnar deviation over the range of -5° to 15° radial-ulnar deviation (RUD). These findings suggest CTV may be too coarse of a measure to reflect the effects of slight non-neutral postures, or that volume is conserved and redistributed due to changes in tunnel morphology with posture. The objective of this study was to assess volume distribution along the length of the carpal tunnel and to quantify regional morphology changes with deviated wrist postures in both FE and RUD. Analysis was performed on a dataset of computed tomography scans collected on ten cadaveric specimens (5 male, 5 female, mean age = 80.7 ± 10.9 years) over a range of FE and RUD postures. The carpal tunnel of each scan was divided into four quartiles of equal length along the tunnel to quantify volume distribution. Volume within the carpal tunnel was seen to redistribute with both FE and RUD. Decreased volume in the distal aspect of the tunnel with flexion and proximal aspect of the tunnel with ulnar deviation may contribute to localized compression of the medial nerve. Measures of mean cross-sectional area, width and depth by quartile provided an indication of the morphology changes associated volume redistribution. Morphology analysis also revealed twisting between the proximal and distal aspects of the tunnel which increased with flexion and ulnar deviation and may further contribute to strain on the median nerve.