The association between gender-affirming care and disordered eating in transgender and gender diverse individuals: Exploring appearance congruence and gender-related motivating factors for weight loss.

OBJECTIVE: The objective of this study is to explore between-group differences across different stages of gender-affirming care, and associations between appearance congruence, gender-related motivations for weight loss, and disordered eating in transgender and gender expansive (TGE) individuals. METHOD: A total of 160 TGE adults (aged 18-30) were recruited across the United States. Participants completed a comprehensive online survey. Data were analyzed using generalized linear models and bivariate correlations. RESULTS: Significant differences in appearance congruence among participants at different transition stages were revealed, with the group that achieved their desired transition reporting the highest appearance congruence compared to all other groups. Furthermore, gender-related motivations for weight loss were significantly lower in individuals who achieved their desired transition compared to those with no plans to transition. DISCUSSION: Findings suggest significantly higher appearance congruence in those who achieved their desired transition compared to other groups, and individuals who attained their desired transition exhibited significantly reduced gender-related motivations for weight loss compared to those with no plans to transition. These findings underscore the potential psychological benefits associated with successful gender-affirming care, highlighting its role not only in fostering appearance congruence but also in mitigating gender-related motivations for weight loss among TGE individuals. Future research should include larger and more diverse samples, longitudinal designs, and considerations of other factors influencing body image outcomes in this population. PUBLIC SIGNIFICANCE: This study sheds light on the crucial relationship between gender-affirming care and body image outcomes in TGE individuals. Understanding how appearance congruence and gender-related motivations for weight loss are associated with disordered eating can inform tailored support and interventions. By recognizing the association of gender affirming care and well-being, healthcare providers can enhance care for TGE individuals.

'Let the ladies know': queer women's perceptions of how gender and sexual orientation shape their eating and weight concerns.

This exploratory study aimed to describe the lived experiences of queer women affected by eating and weight-related concerns. Qualitative data from young queer women (n = 105; Age = 23.6 ± 3.4 years) with eating and weight-related concerns in response to open-ended questions related to the influence of gender identity and body image on weight concern, behaviours, and perception were analysed using reflexive thematic analysis. Nine themes were created to describe participants' experiences: (1) compensation for other internalised stigma, (2) to suppress body parts that can be gendered or sexualised, (3) comparisons to romantic partners' bodies, (4) media representations, (5) queer signalling, (6) queerness as protective, (7) gender expression and dysphoria, (8) societal expectations of women's bodies, and (9) internalisation of body/beauty ideals. Seven sub-themes were created to represent beauty ideals for specific subcultural communities (e.g. femme, butch). Findings suggest that queer women attribute individual, interpersonal and social factors to weight concerns, behaviours and perceptions. Findings highlight how complex tensions between the beauty/body ideals experienced in cisheteronormative and queer spaces influence eating and weight concerns among queer women. Gender, sexual orientation and subcultural ideals intersect in important ways, and may be useful to consider when screening, treating and preventing eating and weight concerns among queer women.

The need for more inclusive measurement to advance equity in eating disorders prevention.

Eating disorder (ED) research and practice have been shaped by prevailing stereotypes about who EDs are most likely to affect. Subsequently, the field has prioritized the needs and concerns of affluent, cisgender, heterosexual, white girls and women to the exclusion of others, especially people marginalized based on their race, ethnicity, sexual orientation, and/or gender identity. However, EDs exist across diverse groups and actually occur with elevated prevalence in several marginalized groups. Growing research points to differences in the drivers of EDs in such groups (e.g. desire to attain the curvy rather than thin ideal; dietary restraint due to food insecurity rather than weight/shape concerns), yet tools typically used for screening and intervention evaluation do not capture eating pathology driven by such factors. In this commentary, we describe gaps in existing ED assessment tools and argue these gaps likely underestimate EDs among marginalized groups, bias who is invited, participates in, and benefits from ED prevention programs, and obscure potential group differences in the efficacy of such programs. We also discuss the potential of these ramifications to exacerbate inequities in EDs. Finally, we outline recommendations to overcome existing gaps in measurement and, consequently, advance equity in the realm of ED prevention.

More Than Identity: An Intersectional Approach to Understanding Mental-Emotional Well-Being of Emerging Adults by Centering Lived Experiences of Marginalization.

Understanding social determinants that shape pertinent developmental shifts during emerging adulthood (i.e., ages 18-25 years) and their associations with psychological health requires a nuanced approach. In our exploratory study, we investigated how multiple social identities and lived experiences generated by systems of marginalization and power (e.g., racism, classism, sexism) intersect in connection to the mental-emotional well-being of emerging adults (EAs). Eating and Activity Over Time (EAT, 2010-2018) data were collected from 1,568 EAs (mean age = 22.2 (standard deviation, 2.0) years) recruited initially in 2010 from Minneapolis/St. Paul schools. Conditional inference tree analyses were employed to treat "social location" and systems of marginalization and power as interdependent social factors influencing EAs' mental-emotional well-being outcomes: depressive symptoms, stress, self-esteem, and self-compassion. Conditional inference tree analyses identified EAs' subgroups with differing mean levels of mental-emotional well-being outcomes, distinguished primarily by marginalized social experiences (e.g., discrimination, financial difficulties) rather than social identities themselves. The relative positioning of EAs' experiences of social marginalization (e.g., discrimination) to their social identities (e.g., race/ethnicity) suggests that the social experiences generated by systems of privilege and oppression (e.g., racism) are more adjacent social determinants of mental-emotional well-being than the social identities used in public health research to proxy the oppressive systems that give them social meaning.

Socioeconomic status and eating disorder prevalence: at the intersections of gender identity, sexual orientation, and race/ethnicity.

BACKGROUND: Longstanding biases have fostered the erroneous notion that only those of higher socioeconomic status (SES) experience eating disorders (EDs); however, EDs present across all SES strata. Considering the dearth of ED research among those of lower SES, this study examined (1) the overall association between SES and ED prevalence, and (2) ED prevalence in the context of four relevant social identities (i.e. SES, gender identity, sexual orientation, and race/ethnicity) from an intersectional perspective, as unique combinations of multiple social identities may differentially influence risk. METHODS: A sample of 120 891 undergraduate/graduate students from the Healthy Minds Study self-reported family SES with a single-item question, gender identity, sexual orientation, and race/ethnicity, and were screened for ED risk. RESULTS: Participants of lower SES had 1.27 (95% CI 1.25-1.30) times greater prevalence of a positive ED screen than those of higher SES. Substantial heterogeneity was observed across the four social identities beyond the association with SES. For example, positive ED screens were particularly common among lower SES, Latinx, sexual minority cisgender men and women, with 52% of bisexual men and 52% of lesbian women of Latinx ethnicity and lower SES screening positive. CONCLUSIONS: Although positive ED screens were more common among undergraduate/graduate students of lower SES, the particularly high ED risk reported by certain groups of lower SES with multiple minority identities reinforces the importance of investigating multi-layered constructs of identity when identifying groups at disproportionate risk.

Exploring the intersection of multiple social determinants of health and disordered eating behaviors in a population-based sample in the United States.

OBJECTIVE: Disordered eating behaviors (DEBs) have long-term, deleterious effects on health and are more prevalent among socially marginalized groups, likely as a result of systemic inequities across social determinants of health (SDoH). This exploratory study aimed to identify subgroups of emerging adults characterized by main and interactive associations between SDoH and two forms of DEB (binge eating, extreme unhealthy weight control behaviors). METHOD: Participants (n = 1568; age 22.2 ± 2.1 years) from the United States were drawn from the EAT 2010-2018 longitudinal study. Conditional inference tree (CIT) analyses derived main and intersecting SDoH related to DEB across 33 input variables collected during adolescence and emerging adulthood. RESULTS: The binge eating CIT revealed five subgroups (prevalence: 6.3-23.2%) shaped by variables collected during emerging adulthood: appearance-based teasing (p < .001), financial difficulty (p = .003), gender (p < .001), and everyday discrimination (p = .008). The CIT results for extreme unhealthy weight control behaviors derived six subgroups (prevalence: 2.3-45.5%) shaped by weight teasing (p < .001) and gender (p < .001) during emerging adulthood and public assistance (p = .008) and neighborhood safety (p = .007) in adolescence. DISCUSSION: This exploratory study revealed distinct subgroups of emerging adults with varying DEB prevalence, suggesting that variability in DEB prevalence may be partially explained by intersecting SDoH during adolescence and emerging adulthood. Hypothesis-driven research and replication studies are needed to further explore the associations between SDoH and DEB during emerging adulthood. PUBLIC SIGNIFICANCE STATEMENT: Disordered eating behaviors are common among young people in the United States and have long-term health consequences. This exploratory study identified subgroups of young people, characterized by combinations of social inequities (e.g., financial difficulties, teasing). Results highlight high-risk subgroups of emerging adults that should be examined further in hypothesis-driven research.

Diet pill and laxative use for weight control predicts first-time receipt of an eating disorder diagnosis within the next 5 years among female adolescents and young adults.

OBJECTIVE: To replicate findings from a prior study which identified prospective associations between use of products for weight control and subsequent receipt of a first-time eating disorder (ED) diagnosis among female adolescents and young adults. METHOD: Data from a prospective cohort study, Project EAT (Eating and Activity in Teens and Young Adults), were used to examine prospective associations between self-reported past-year diet pill and laxative use for weight control and self-reported receipt of an ED diagnosis among females without prior receipt of an ED diagnosis (N = 1,015). Participants were followed from early/middle adolescence (EAT-I; Mage  = 14.9 years) into late adolescence/emerging adulthood (EAT-II; Mage  = 19.5 years) and young adulthood (EAT-III; Mage  = 24.8 years). RESULTS: First-time receipt of an ED diagnosis was reported by 2.4% of participants at EAT-II and 4.0% at EAT-III. After adjusting for demographics and weight status, participants using diet pills (risk ratio [RR] = 3.58, 95% confidence interval [CI]: 1.96-6.54) and laxatives (RR = 2.77, 95% CI: 1.01-7.64) had greater risk of receiving a first-time ED diagnosis within 5 years than those not using these products. DISCUSSION: The present study replicated prior findings, providing further evidence for a prospective link between use of products for weight control and subsequent receipt of an ED diagnosis.

The longitudinal relationship between family and peer teasing in young adulthood and later unhealthy weight control behaviors: The mediating role of body image.

OBJECTIVE: Sociocultural theories hold that family and peer weight-related teasing increases the risk for unhealthy weight control behaviors (UWCBs) by negatively impacting body image. Although much cross-sectional support exists for these pathways, longitudinal data are lacking. This study tested the longitudinal relationships among peer and family teasing (occurrence and perceived impact) in early adolescence, body satisfaction in late adolescence, and UWCBs in young adulthood among a racially/ethnically and socioeconomically diverse population. METHOD: Data were drawn from three waves of Project EAT over a 15-year period (Eating and Activity in Teens and Young Adults), and included responses from 1,902 young adults (57% female). RESULTS: Among female participants, a mediated indirect pathway emerged with family weight-related teasing predicting increased engagement in UWCBs in early adulthood via poorer body image in late adolescence. In contrast, peer teasing did not predict body image or UWCBs. Among boys, the mediated indirect pathways were not significant. However, poor body image in late adolescent males predicted higher likelihood of engaging in UCWBs in early adulthood. DISCUSSION: These findings support the long-term impact of family weight-related teasing on greater risk for UWCBs among girls and young women, and poor body image as a mechanism accounting for this relationship. Moreover, the results highlight the poor body image among adolescent boys as a factor for increased risk of engaging in UWCBs in early adulthood. Pending replication in current cohorts, health promotion and prevention involving family members of early adolescents that address family weight teasing and body image are needed.

Disordered eating in a population-based sample of young adults during the COVID-19 outbreak.

OBJECTIVE: The present study aimed to describe the experience of, and factors associated with, disordered eating in a population-based sample of emerging adults during the COVID-19 outbreak. METHOD: Participants in the EAT 2010-2018 (Eating and Activity over Time) study were invited to complete the C-EAT (COVID-19 EAT) survey in April-May 2020. There were 720 respondents to the survey (age: 24.7 ± 2.0 years). Psychological distress, stress, stress management, financial difficulties, and food insecurity during the COVID-19 pandemic were examined as cross-sectional correlates of disordered eating in 2020. Open-ended questions assessed the perceived impact of the pandemic on eating behaviors. RESULTS: Low stress management was significantly associated with a higher count of extreme unhealthy weight control behaviors (UWCBs). Food insecurity, higher depressive symptoms, and financial difficulties were significantly associated with a higher count of less extreme UWCBs. Higher stress and depressive symptoms were significantly associated with greater odds of binge eating. Six themes pertaining to disordered eating during the pandemic emerged: (a) mindless eating and snacking; (b) increased food consumption; (c) generalized decrease in appetite or dietary intake; (d) eating to cope; (e) pandemic-related reductions in dietary intake; and (f) re-emergence or marked increase in eating disorder symptoms. DISCUSSION: Psychological distress, stress management, financial difficulties, and abrupt schedule changes may have contributed to disordered eating during the COVID-19 pandemic. Interventions that target stress management, depressive symptoms, and financial strain and provide tools to develop a routine may be particularly effective for emerging adults at risk of developing disordered eating during public health crises.

Sexual Orientation-Based Differential Item Functioning in Measures of Body Image Concerns and Ideals among Men.

Body image concerns and body ideals are linked with eating disorders and psychological health. Body image and ideals among men differ by sexual orientation, which may influence the utility of common measures of such constructs. The present study used differential item functioning (DIF) analyses to examine whether item endorsement differs as a function of sexual orientation in three commonly used measures of body image concerns and ideals. Participants were sexual minority (n=209) and heterosexual (n=494) men in the United States. Scores on the Drive for Muscularity Scale (DMS), Sociocultural Attitudes Towards Appearance Questionnaire-4 (SATAQ-4), and Objectified Body Consciousness Scale (OBCS) were examined. DIF was tested in a three-step regression wherein item scores were predicted by: (1) subscale score, (2) subscale and sexual orientation, and (3) subscale, sexual orientation and their product term. Model fit and variance explain comparisons identified DIF. Δ pseudo R2 value ≥ .035 from step 1 to 3 signified clinical significant DIF. There was no evidence of clinically significant DIF for the DMS, SATAQ-4, or OBSC. Findings suggest that DMS, SATAQ-4, and OBSC perform similarly for sexual minority and heterosexual men.

Weight discrimination inflates psychological health risk and academic impairment in sexual minority cisgender college students relative to their heterosexual peers.

This study examined whether exposure to weight discrimination modified the association between sexual orientation, self-reported eating disorders, self-reported depression and academic impairment in a large sample of college students. Participants (n = 13,782) were from the 2015-2018 College Student Health Survey. Logistic regressions tested whether weight discrimination magnified psychological health concerns and academic impairment in sexual minority students (i.e., lesbian, gay) relative to their heterosexual peers and were stratified by gender (cisgender men and cisgender women). Sexual minority men and women reported more weight discrimination, eating disorders, depression, and academic impairment than their heterosexual peers, even after controlling for BMI and race. Among sexual minority men and women, weight discrimination was associated with increased eating disorders and academic impairment, but not depression. Weight discrimination increased the rate of eating disorders, depression, and academic impairment, however, the rate was still higher among sexual minority students regardless of weight discrimination status or gender. College-based interventions should aim to reduce weight stigmatization and its associated influence on psychological health and academic functioning, and address the needs of sexual minority college students, as they may be at highest risk. Clinicians should work to reduce the harms of weight discrimination, particularly in sexual minority young adults.

Differential item functioning analysis for the Eating Disorder Examination Questionnaire among heterosexual and sexual minority men.

PURPOSE: Sexual minority (SM) men are at a higher risk for eating disorders and related issues, relative to heterosexual men. However, it is currently unknown whether commonly used measures of eating pathology are appropriate to use among diverse groups of men. Determining the unique functioning of existing assessments may help better and more accurately understand eating disorder pathology within this population. The present study examined differences in item endorsement between sexual orientation in the Eating Disorder Examination Questionnaire (EDE-Q) through differential item functioning (DIF). METHODS: Heterosexual and SM men (N = 703) completed the EDE-Q and a demographic questionnaire. EDE-Q scores were examined for clinically significant DIF based on participants' self-reported sexual orientation (e.g., heterosexual men vs SM men). RESULTS: SM men reported higher EDE-Q symptom composite scores than heterosexual men. DIF was observed for all EDE-Q items relative to the global score; however, only one item met clinical significance (EDE-Q #19; ∆R2 ≥ 0.13). CONCLUSION: Results suggest that SM men experience greater levels of ED pathology than heterosexual men. While the EDE-Q is a commonly used measure of eating pathology, findings suggest that sexual orientation bias may impact many items on the EDE-Q. However, results from this study indicated that only one item introduces bias that has clinical implications. Additional research is needed to further explore and replicate this finding among more diverse samples of SM and heterosexual men. LEVEL OF EVIDENCE: Level III, case-control analytic study.

Intuitive eating longitudinally predicts better psychological health and lower use of disordered eating behaviors: findings from EAT 2010-2018.

PURPOSE: To examine longitudinal associations of intuitive eating (IE), defined as eating according to internal hunger and satiety cues, with psychological health outcomes and disordered eating behaviors. METHODS: Data from a diverse sample of 1491 participants (54.1% female, 19.7% non-Hispanic white) followed from adolescence (baseline; Mage = 14.5 years) into young adulthood (follow-up; Mage = 22.2 years) came from the population-based EAT 2010-2018 (Eating and Activity over Time) study. Logistic regression models predicting psychological health outcomes and disordered eating behaviors at follow-up simultaneously included baseline IE and change in IE from baseline to follow-up as predictors, adjusting for demographic covariates, body mass index, and outcome at baseline. RESULTS: Greater baseline IE and increases in IE from baseline to follow-up were both associated with lower odds of high depressive symptoms, low self-esteem, high body dissatisfaction, unhealthy weight control behaviors (e.g., fasting, skipping meals), extreme weight control behaviors (e.g., taking diet pills, vomiting), and binge eating at 8-year follow-up. Particularly strong protective associations were observed for binge eating, such that a one-point higher IE score at baseline was associated with 74% lower odds of binge eating at follow-up, and a one-point higher increase in IE score from baseline to follow-up was associated with 71% lower odds of binge eating at follow-up. CONCLUSIONS: These results indicate that IE longitudinally predicts better psychological and behavioral health across a range of outcomes and suggest that IE may be a valuable intervention target for improving psychological health and reducing disordered eating behaviors, particularly binge eating. LEVEL OF EVIDENCE: Level III, cohort study.

Disparities in self-reported eating disorders and academic impairment in sexual and gender minority college students relative to their heterosexual and cisgender peers.

OBJECTIVE: The purpose of the current study was threefold: (a) compare rates of self-reported anorexia nervosa (AN), self-reported bulimia nervosa (BN), and eating pathology-specific academic impairment (EAI) by gender identity (cisgender men, cisgender women, transgender or genderqueer) and sexual orientation (gay or lesbian, bisexual, unsure, other), (b) examine associations between gender identity, sexual orientation, and eating outcomes, and (c) identify for whom rates of eating disorder diagnosis and impairment is greatest. METHOD: The study includes a sample of Minnesota students (n = 13,906) who participated in the College Student Health Survey from 2015 to 2018. Chi-square tests with bootstrapping examined differences in eating pathology rates between groups. Adjusted logistic regressions tested the association between gender identity, sexual orientation, and self-reported eating outcomes. RESULTS: Chi-square results revealed heightened rates of self-reported AN, self-reported BN, and EAI in cisgender women, transgender or genderqueer, and sexual minority (e.g., lesbian or bisexual) students. Logistic regression analyses in cisgender men and cisgender women revealed higher odds of self-reported AN, self-reported BN, and EAI in sexual minority students relative their heterosexual peers. Chi-square analyses indicated that bisexual cisgender women reported heightened rates of all three eating pathology measures relative to other sexual and/or gender (e.g., transgender) minority students. DISCUSSION: Individuals with marginalized gender and/or sexual orientation identities report heightened rates of eating pathology, with cisgender bisexual women reporting the poorest outcomes relative to individuals from other marginalized identities. Preventive efforts and more research are needed to understand the mechanisms driving this disparity and to reduce prevalence among marginalized groups.

Disparities in eating disorder risk and diagnosis among sexual minority college students: Findings from the national Healthy Minds Study.

OBJECTIVE: To examine differences in eating disorder (ED) risk and diagnosis by sexual orientation in a national sample of college students. METHOD: Data from 178 U.S. colleges and universities participating in the Healthy Minds Study between 2016 and 2019 were analyzed (36,691 cisgender men, 81,730 cisgender women; 15.7% self-identifying as sexual minorities). Outcomes were ED risk (≥2 on the SCOFF) and self-reported lifetime ED diagnosis. Prevalence estimates adjusted for demographics and weight status were computed via logistic regression. RESULTS: Higher proportions of questioning (29.1%), bisexual (26.3%), and gay men (30.9%) exhibited elevated risk than heterosexual men (14.3%), and a higher proportion of gay men exhibited elevated risk than bisexual men. Higher proportions of questioning (34.5%) and bisexual women (34.6%) exhibited elevated risk than heterosexual women (27.6%); proportions of lesbian (28.1%) and heterosexual women were similar. Among those with elevated risk, higher proportions of bisexual (5.0%) and gay men (7.1%) and of questioning (14.7%), bisexual (18.1%), and lesbian women (19.6%) had been diagnosed relative to heterosexual men (2.0%) and heterosexual women (10.3%), respectively. DISCUSSION: Questioning and bisexual individuals appear to be particularly vulnerable; they may experience elevated ED risk relative to their heterosexual peers yet underdiagnosis relative to their gay or lesbian peers.

Examining vegetarianism, weight motivations, and eating disorder psychopathology among college students.

OBJECTIVE: Previous research has suggested a link between vegetarianism, broadly defined, and symptoms of eating disorders (ED). However, the literature supporting this link is mixed and limited by possible measurement artifacts. Using data from a national sample of college students, the present study examines ED symptomatology among three groups: (a) vegetarians whose meat avoidance is motivated by weight concerns; (b) non-weight motivated vegetarians; and (c) nonvegetarians. METHOD: Participants include 9,910 students from 12 colleges and universities across the United States who participated in the web-based Healthy Bodies Study. ED symptomatology was measured using the Short-Eating Disorder Examination-Questionnaire (S-EDE-Q). First, multi-group confirmatory factor analysis was conducted to test measurement invariance (MI) of the S-EDE-Q across weight-motivated vegetarians, non-weight-motivated vegetarians, and nonvegetarians. Gender- and BMI-adjusted ANCOVA was used to compare S-EDE-Q scores across groups. RESULTS: 9.3% of participants were vegetarian. Cis-women and gender minority students were more likely to be vegetarian; those who became vegetarians after entering college were more likely to report weight-related motivations. Strict MI was supported for the S-EDE-Q global and subscale scores. Weight-motivated vegetarians reported higher levels of restraint, shape/weight overvaluation, body dissatisfaction, and global ED psychopathology relative to other participants. DISCUSSION: To our knowledge, this is the first to explicitly link weight motivations for vegetarianism to ED psychopathology in a large, representative sample of young adults. Results suggest that students presenting with ED symptoms should be assessed for their motivations for adopting a vegetarian diet, and this information should be considered in treatment decisions.

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.

The importance of face-to-face contact and reciprocal relationships and their associations with depressive symptoms and life satisfaction.

OBJECTIVE: The current study aimed to examine how patterns of interpersonal relational contexts (e.g., face-to-face or technology-based) and processes (e.g., initiated or accepted) relate to depressive symptomology and life satisfaction. METHODS: Participants were recruited through Amazon's Mechanical Turk (n = 962 adults [52.1% female; aged 18-78; 16.4% Non-White]). Quota sampling was used to closely match the sample demographics to that of the United States Census data. Latent class analyses (LCA) identified classes of interpersonal relations using the Multidimensional Interpersonal Relations Scale. Next, participants' responses on the Beck Depression Inventory and Satisfaction With Life Scale were examined to evaluate differences in depressive symptoms and life satisfaction across classes. RESULTS: LCA results supported a 4-class model, in which classes were characterized by patterns of relational contexts and processes: Class 1 (50.6%) engagement across all contexts (e.g., face-to-face) and processes (e.g., initiated); Class 2 (12.7%) engagement across all contexts and processes except Facebook; Class 3 (24.0%) engagement in all contexts and only passive processes; and Class 4 (12.7%) engagement in only technology-based contexts and passive processes. Membership in Classes 1 and 2 was associated with lower depressive symptomology and higher life satisfaction as compared to Classes 3 and 4. CONCLUSION: The findings suggest that patterns of relations differentially relate to depressive symptoms and life satisfaction. The findings suggest that multicontextual (e.g., face-to-face and technology-based) and reciprocal relationships with friends (e.g., initiating and accepting connections) may play an important role in the association between interpersonal relations with life satisfaction and depressive symptoms.

The Dynamic Relationship between Unhealthy Weight Control and Adolescent Friendships: A Social Network Approach.

Although adolescence marks a vulnerable stage for peer influence on health behavior, little is known about the longitudinal and dynamic relationship between adolescent friendship and weight control. The current study aims to explain these dynamic processes among a sample of 1156 American adolescents in grades 9-11 (48.6% girls, 23.4% European American, 25.2% African American) from the National Longitudinal Study of Adolescent Health. Stochastic actor-oriented models were fit to examine changes in friendship networks and unhealthy weight control across two waves. The findings support a bidirectional relationship where weight control predicts future friendship seeking and friendship seeking predicts future weight control. The findings also indicate that adolescents prefer friends with similar weight control patterns. Taken together, the results of the current study indicate that adolescent friendships play an integral role in the development of unhealthy weight control and thus can be used to identify adolescents at risk and serve as targets within preventive interventions.