Generalized network psychometrics of eating-disorder psychopathology.

OBJECTIVE: As network models of eating disorder (ED) psychopathology become increasingly popular in modeling symptom interconnectedness and identifying potential treatment targets, it is necessary to contextualize their performance against other methods of modeling ED psychopathology and to evaluate potential ways to optimize and capitalize on their use. To accomplish these goals, we used generalized network psychometrics to estimate and compare latent variable models and network models, as well as hybrid models. METHOD: We tested the structure of the Eating Pathology Symptoms Inventory (EPSI) and Eating Disorder Examination-Questionnaire (EDE-Q) in Recovery Record, Inc. mobile phone application users (N = 6856). RESULTS: Although all models fit well, results favored a hybrid latent variable and network framework, which showed that ED symptoms fit best when modeled as higher-order constructs, rather than direct symptom-to-symptom connections, and when the relationships between those constructs are described as a network. Hybrid models in which latent factors were modeled as nodes within a network showed that EPSI Purging, Binge Eating, Cognitive Restraint, Body Dissatisfaction, and Excessive Exercise had high importance in the network. EDE-Q Eating Concern and Shape Concern were also important nodes. Results showed that the EPSI network was highly stable and replicable, whereas the EDE-Q network was not. DISCUSSION: Integrating latent variable and network model frameworks enables tests of centrality to identify important latent variables, such as purging, that may promote the spread of ED psychopathology throughout a network, allowing for the identification of future treatment targets.

Screening for eating disorders across genders in college students: Initial validation of the brief assessment of stress and eating.

Given that eating disorders (EDs) are relatively common in college populations, it is important to have reliable and valid tools to identify students so that they can be referred to evidence-based care. Although research supports the psychometric properties of existing ED screens for identifying cases of EDs, most studies have been conducted in samples of young white-majority women or have not reported the psychometric properties of the screening tool in men. OBJECTIVE: The purpose of the current study was to validate a brief, 10-item screening tool for the identification of EDs-the brief assessment of stress and eating (BASE). METHOD: Participants were college students (N = 596; 68.2% cisgender women) from a large Midwestern university who completed the BASE and SCOFF. The Eating Disorders Diagnostic Survey was used to generate DSM-5 ED diagnoses. We evaluated area under the curve (AUC) for both receiver operating curves (ROC) and precision-recall curves (PRC). RESULTS: Both the BASE and SCOFF performed significantly better than chance at identifying probable EDs in cisgender women (BASE AUC: ROC = .787, PRC = .633, sensitivity = .733, specificity = .697; SCOFF AUC: ROC = .810, PRC = .684, sensitivity = .793, specificity = .701). However, the BASE (AUC: ROC = .821, PRC = .605, sensitivity = .966, specificity = .495) significantly outperformed the SCOFF (AUC: ROC = .710, PRC = .354, sensitivity = .828, specificity = .514) for identifying probable EDs in cisgender college men. DISCUSSION: The BASE is appropriate for student healthcare and college research settings. Because the BASE outperforms the SCOFF in college men, results from the current study are expected to contribute to improved identification of EDs on college campuses. PUBLIC SIGNIFICANCE: The BASE is a new screening tool to identify eating disorders. The BASE performed as well as, if not better than, the SCOFF (particularly in men). Given the need for brief, psychometrically strong, and unbiased ED screening tools in college students, the current study helps address an unmet student healthcare need that we expect will contribute to improved identification of EDs on college campuses.

Beneath the surface: Abstract construal mindset increases receptivity to metaphors in health communications.

Widespread messages use metaphoric language and imagery to prompt recipients to interpret health-related concepts in terms of dissimilar, familiar concepts (e.g., "fight the war on cancer"). When do these messages work? According to Conceptual Metaphor Theory, thinking metaphorically involves looking past concepts' superficial differences to identify their similarities at a structural level. Thus, we hypothesized that when people's general construal mindset is oriented to focus on information's abstract meaning, not its concrete details, they would process a metaphor's target health concept in ways that correspond to the dissimilar concept. Accordingly, after priming an abstract, but not concrete, construal mindset: framing sun exposure as enemy confrontation (vs. literally) increased cancer risk perceptions and sun-safe intentions (Study 1; N=186); and framing smoking cessation as an arduous journey (vs. literally) increased appreciation of quitting difficulties and interest in cessation tools (Study 2; N=244). We discuss practical and theoretical implications for improving health communication.

Design and methods of the Longitudinal Eating Disorders Assessment Project research consortium for veterans.

INTRODUCTION: Military service members must maintain a certain body mass index and body fat percentage. Due to weight-loss pressures, some service members may resort to unhealthy behaviors that place them at risk for the development of an eating disorder (ED). OBJECTIVES: To understand the scope and impact of EDs in military service members and veterans, we formed the Longitudinal Eating Disorders Assessment Project (LEAP) Consortium. LEAP aims to develop novel screening, assessment, classification, and treatment tools for veterans and military members with a focus on EDs and internalizing psychopathology. METHODS: We recruited two independent nationally representative samples of post-9/11 veterans who were separated from service within the past year. Study 1 was a four-wave longitudinal survey and Study 2 was a mixed-methods study that included surveys, structured-clinical interviews, and qualitative interviews. RESULTS: Recruitment samples were representative of the full population of recently separated veterans. Sample weights were created to adjust for sources of non-response bias to the baseline survey. Attrition was low relative to past studies of this population, with only (younger) age predicting attrition at 1-week follow-up. CONCLUSIONS: We expect that the LEAP Consortium data will contribute to improved information about EDs in veterans, a serious and understudied problem.

Cognitive networks detect structural patterns and emotional complexity in suicide notes.

Communicating one's mindset means transmitting complex relationships between concepts and emotions. Using network science and word co-occurrences, we reconstruct conceptual associations as communicated in 139 genuine suicide notes, i.e., notes left by individuals who took their lives. We find that, despite their negative context, suicide notes are surprisingly positively valenced. Through emotional profiling, their ending statements are found to be markedly more emotional than their main body: The ending sentences in suicide notes elicit deeper fear/sadness but also stronger joy/trust and anticipation than the main body. Furthermore, by using data from the Emotional Recall Task, we model emotional transitions within these notes as co-occurrence networks and compare their structure against emotional recalls from mentally healthy individuals. Supported by psychological literature, we introduce emotional complexity as an affective analog of structural balance theory, measuring how elementary cycles (closed triads) of emotion co-occurrences mix positive, negative and neutral states in narratives and recollections. At the group level, authors of suicide narratives display a higher complexity than healthy individuals, i.e., lower levels of coherently valenced emotional states in triads. An entropy measure identified a similar tendency for suicide notes to shift more frequently between contrasting emotional states. Both the groups of authors of suicide notes and healthy individuals exhibit less complexity than random expectation. Our results demonstrate that suicide notes possess highly structured and contrastive narratives of emotions, more complex than expected by null models and healthy populations.