Understanding the effects of reductionist biological views of eating disorder etiology on patient attitudes and behavior.

While eating disorders were historically considered to be a result of psychological or environmental causes, current evidence suggests that eating disorders are the product of complex gene-environment interactions wherein heritable vulnerabilities are activated by multiple exposures to environmental stimuli over the lifespan. Despite the fact that this integrated biopsychosocial etiological view of eating disorders is accepted among many professionals in the eating disorder field, evidence suggests that the general public and some clinicians are susceptible to dualist, or reductionist, views of psychopathology. Currently, little is known about (a) the prevalence of reductionist biological views of eating disorder etiology in those with eating disorders (this view attributes the cause of eating disorders to predominantly biological factors but does not acknowledge psychosocial factors as important contributors), (b) the effects of reductionist biological views on clinical outcomes, and (c) the most effective methods for modifying these views. In this article, we present the results of a preliminary investigation on the relationship between perceived causes of eating disorders and the attitudes and behaviors of those with eating disorders. We then go on to propose specific avenues for further research on uncovering the effects of reductionist biological views of eating disorder etiology.

The costs and benefits of intensive day treatment programs and outpatient treatments for eating disorders: An idea worth researching.

Outpatient care (e.g., individual, group, or self-help therapies) and day treatment programs (DTPs) are common and effective treatments for adults with eating disorders. Compared to outpatient care, DTPs have additional expenses and could have unintended iatrogenic effects (e.g., may create an overly protective environment that undermines self-efficacy). However, these potential downsides may be offset if DTPs are shown to have advantages over outpatient care. To explore this question, our team conducted a scoping review that aimed to synthesize the existing body of adult eating disorder literature (a) comparing outcomes for DTPs to outpatient care, and (b) examining the use of DTPs as a higher level of care in a stepped care model. Only four studies met the predefined search criteria. The limited results suggest that the treatments have similar effects and that outpatient care is more cost-effective. Furthermore, no studies explored the use of DTPs as a higher level of care in a stepped care model (despite international guidelines recommending this approach). Given the clear dearth of literature on this clinically relevant topic, we have provided specific avenues for further research.

Social influences on binge drinking in emerging adults: Which social network members matter most?

BACKGROUND: Binge drinking peaks in emerging adulthood and is associated with a myriad of negative consequences. Research indicates that social network members have a significant influence on binge drinking. In particular, theory suggests that drinking habits of romantic partners and peers have a stronger influence on emerging-adult binge drinking than do drinking habits of siblings and parents. We investigated the relative influences of siblings, parents, romantic partners, and peers on emerging adults' binge drinking using a multisource design and a robust measure of binge drinking. We hypothesized peer and romantic partner binge drinking would more strongly predict emerging-adult (egos) binge drinking than would parent and sibling binge drinking. Methods: We recruited 321 participants (egos) aged 17-25 years, alongside 882 members of their social network (alters). Egos and alters completed self-report measures of binge drinking (frequency, quantity, and self-perception). Results: Structural equation modeling revealed that the direct positive effect from romantic partner binge drinking to ego binge drinking was significant. In contrast, the direct effects from peer, parent, and sibling binge drinking to ego binge drinking were nonsignificant. Conclusion: In emerging adulthood, romantic partners appear to have the strongest association with ego binge drinking.

Different drugs come with different motives: Examining motives for substance use among people who engage in polysubstance use undergoing methadone maintenance therapy (MMT).

BACKGROUND: Substance use motives (i.e., reasons for using a substance) are thought to be the most proximal variable leading to substance use. These motives have been described by various typologies, the most well known being the four-factor drinking motives model which separates motives into enhancement, social, coping, and conformity (Cooper, 1994). Although extensively studied in adult community samples, motives for use have less commonly been investigated among populations at a later stage of addiction, where polysubstance use is more common. Moreover, because the motives literature has largely focused on drinking motives, it is not clear whether existing findings can also be applied to other substances (Cooper et al., 2016). METHODS: Using Zero-inflated beta Bayesian linear mixed modeling, we investigated the stability of seven distinct substance use motives (enhancement, social, expansion, coping with anxiety, coping with depression, coping with withdrawal, and conformity) across six different drug categories (tobacco, alcohol, cannabis, opioids, stimulants, and tranquilisers) to determine the extent to which drug class can influence motive endorsement. One-hundred-and-thirty-eight methadone maintenance therapy (MMT) clients (F = 34.1%; M = 65.9%; age = 40.18 years) completed a novel short-form polysubstance motives questionnaire. RESULTS: External motives (i.e., conformity and social motives) were the most stable across drug categories, while all internal motives (i.e., enhancement, expansion, and all three coping motives) demonstrated varying levels of inter-drug variability. CONCLUSIONS: These findings have important implications for prevention and intervention strategies among people who engage in polysubstance use, highlighting the importance of both universal and substance-specific programming.

Do romantic partners influence each other's heavy episodic drinking? Support for the partner influence hypothesis in a three-year longitudinal study.

BACKGROUND: Approximately one in five adults engage in heavy episodic drinking (HED), a behavior with serious health and social consequences. Environmental, intrapersonal, and interpersonal factors contribute to and perpetuate HED. Prior research supports the partner influence hypothesis where partners influence each other's HED. OBJECTIVES: We examined the partner influence hypothesis longitudinally over three years in heterosexual couples in serious romantic relationships, while exploring possible sex differences in the magnitude of partner influence. METHODS: One-hundred-and-seventy-nine heterosexual couples in serious relationships (38.5% married at baseline) completed a measure of HED at baseline and again three years later. RESULTS: Using actor-partner interdependence modelling, results showed actor effects for both men and women, with HED remaining stable for each partner from baseline to follow-up. Significant partner effects were found for both men and women, who both positively influenced their partners' HED over the three-year follow-up. CONCLUSIONS: The partner influence hypothesis was supported. Results indicated partner influences on HED occur over the longer term and apply to partners in varying stages of serious romantic relationships (e.g., cohabiting, engaged, married). Women were found to influence their partners' HED just as much as men influence their partners' HED. Findings suggest HED should be assessed and treated as a couples' issue rather than simply as an individual risky behavior.