Affect and disordered eating behaviours in women's daily lives: The comparative explanatory roles of distinct momentary emotion dysregulation dimensions.

OBJECTIVE: The present study aimed to examine: (a) whether distinct momentary emotion dysregulation dimensions differentially mediated momentary associations between affect and disordered eating behaviours (DEBs) in the natural environment; (b) whether these associations differed based on affect, emotion dysregulation, and DEB type. METHOD: 150 women with eating disorder pathology (Mage = 20.95, SD = 4.14) completed 4 surveys targeting affect, emotion dysregulation, and DEBs each day for a 10-day ecological momentary assessment period. Multilevel structural equation models examined whether four momentary emotion dysregulation dimensions (difficulties with emotional and behavioural modulation, lack of emotional acceptance, awareness, and clarity) mediated momentary associations between negative and positive affect (PA), and loss of control eating, overeating, and dietary restriction. RESULTS: Momentary difficulties with emotional and behavioural modulation mediated momentary associations between negative affect (NA) and women's loss of control eating and overeating. These findings did not extend to PA, the other emotion dysregulation dimensions, or dietary restriction. CONCLUSIONS: Collectively, these results support emotional and behavioural modulation deficits in the natural environment as potential transdiagnostic maintenance mechanisms of overeating and loss of control eating. These findings also support the potential benefits of targeting NA and this type of emotion dysregulation in existing and novel real-time eating disorders interventions.

Expanding a Behavioral View on Digital Health Access: Drivers and Strategies to Promote Equity.

The potential and threat of digital tools to achieve health equity has been highlighted for over a decade, but the success of achieving equitable access to health technologies remains challenging. Our paper addresses renewed concerns regarding equity in digital health access that were deepened during the COVID-19 pandemic. Our viewpoint is that (1) digital health tools have the potential to improve health equity if equitable access is achieved, and (2) improving access and equity in digital health can be strengthened by considering behavioral science-based strategies embedded in all phases of tool development. Using behavioral, equity, and access frameworks allowed for a unique and comprehensive exploration of current drivers of digital health inequities. This paper aims to present a compilation of strategies that can potentially have an actionable impact on digital health equity. Multilevel factors drive unequal access, so strategies require action from tool developers, individual delivery agents, organizations, and systems to effect change. Strategies were shaped with a behavioral medicine focus as the field has a unique role in improving digital health access; arguably, all digital tools require the user (individual, provider, and health system) to change behavior by engaging with the technology to generate impact. This paper presents a model that emphasizes using multilevel strategies across design, delivery, dissemination, and sustainment stages to advance digital health access and foster health equity.

Trajectories of negative affect prior to and following disordered eating behaviors among women with eating disorder pathology: An examination of the role of state-interoception.

OBJECTIVE: Affect regulation theories of eating disorders (ED) posit that negative affect increases in the hours before and decreases following disordered eating behaviors (DEBs) in daily life, yet findings from studies assessing affective changes post-DEBs are mixed. This inconsistency may be due to the previously unassessed role of other transdiagnostic processes in these associations, such as interoception (the ability to sense and integrate information from bodily sensations). To address this research gap, the present study examined whether different interoception dimensions moderated negative affect trajectories surrounding DEBs in the natural environment. METHOD: 150 women with ED pathology (Mage = 21.0, SD = 4.1) completed 4 surveys targeting affect and DEBs each day for a 10-day ecological momentary assessment period. Polynomial multilevel models examined negative affect trajectories pre- and post-DEBs (dietary restriction, overeating, loss of control eating), and whether these trajectories varied based on daily interoception dimensions (not distracting, self-regulation, body listening and trust). RESULTS: Negative affect increased prior to loss of control eating-but not dietary restriction or overeating-and decreased following all DEBs. Further, the magnitude of the decrease in negative affect that emerged post-dietary restriction decreased in strength as daily "not distracting" interoception increased. The other interoception dimensions did not moderate negative affect trajectories surrounding DEBs. CONCLUSIONS: Allowing oneself to experience (vs. distract from) uncomfortable bodily sensations may weaken affect dysregulation processes that follow dietary restriction in daily life and are theorized to maintain DEBs. These results provide insight that may strengthen EDs theories, research, and inform interoception-focused interventions.

Daily Relationship Functioning and Disordered Eating Behaviors Among Sexual Minority Women in Same-Sex Relationships.

BACKGROUND AND PURPOSE: The present study aimed to examine associations between different types of relationship functioning and disordered eating behaviors (DEBs) in the everyday lives of sexual minority women in same-sex relationships-an at-risk population that has not been assessed in this context. METHODS: Participants included 321 young sexual minority women (Mage = 27.56, SD = 3.67) in same-sex relationships who completed surveys assessing their daily relationship functioning and DEB use each day for a 14-day daily diary period. Multilevel structural equation modeling was used to examine daily-, person-, and couple-level associations among women's daily relationship functioning (general relationship functioning, positive and negative relational behaviors they and, separately, their partners engaged in) and DEBs (overeating, loss of control eating, emotional eating, and dietary restriction). RESULTS: Results generally indicated that more positive and less negative daily relationship functioning across all assessed constructs was associated with less same-day emotional eating. In contrast, associations between all daily relationship functioning constructs and loss of control eating were not significant, nor were any relationship functioning-DEB associations at the couple level. More circumscribed patterns of association were identified for associations between the relationship functioning constructs, and overeating and dietary restriction. CONCLUSIONS: Collectively, these findings provide insight into how aspects of daily relationship functioning map onto sexual minority women's daily engagement in DEBs that are linked to poor health long-term, and directions for future research and clinical practice that may warrant consideration moving forward to help advance the evidence-base and care for this historically overlooked and underserved population.

The present study examined associations between different types of relationship functioning (e.g., general relationship functioning, positive and negative relational behaviors that participants and their partners engaged in during their interactions with one another) and disordered eating behaviors (DEBs) in the everyday lives of sexual minority women in same-sex relationships. Results generally indicated that on days when women reported more positive and less negative daily relationship functioning, they also reported less emotional eating that day. In contrast, associations between different types of daily relationship functioning and loss of control eating were not significant. Furthermore, associations between different types of daily relationship functioning relative to overeating and dietary restriction varied based on the type of relationship functioning and DEB under consideration. Collectively, these findings provide insight into how different types of daily relationship functioning map onto sexual minority women's daily engagement in DEBs that are linked to poor health long-term. These findings also provide directions for future research and clinical practice that may warrant consideration moving forward to help advance the evidence base and care for this historically overlooked and underserved population.

Temporal Sequencing of Naturalistic Associations Between Body Satisfaction and Physical Activity: An Ecological Momentary Assessment Study Among Women in Midlife With Elevated Cardiovascular Risk.

The goal of the present study was to examine naturalistic associations between body satisfaction and physical activity (PA) among women in midlife. Women 40-60 years of age with cardiovascular risk factors (e.g., hypertension; N = 75; Mage = 51.63) responded to five surveys per day for 10 days while accelerometer-derived PA measurements were collected continuously. PA parameters included cognitive determinants (PA motivation and intentions) and accelerometer-measured PA behavior (sedentary behavior, light-intensity PA, and moderate to vigorous PA). Multilevel models indicated that associations between body satisfaction and everyday PA differed across PA determinants, time frames (concurrent and prospective), and levels (momentary, daily, and person). For example, positive bidirectional associations were identified between women's daily body satisfaction and PA motivation, whereas greater momentary light-intensity PA (but not moderate to vigorous PA) was unidirectionally associated with greater body satisfaction at a subsequent prompt. These findings provide insight into how associations between body satisfaction and PA unfold in the daily lives of women in midlife and highlight the complexities of these associations.

Refining an ecological momentary assessment study of binge eating among sexual minority and heterosexual young women: a mixed methods pilot study.

Background: Ecological momentary assessment (EMA) is used to capture daily lived experiences, states, and environments. Although EMA is commonly used in behavioral health research, there remains a dearth of literature on how researchers account for design considerations of EMA techniques when designing studies. The goal of this formative mixed methods study was to elicit feedback on EMA study procedures and materials from the target populations for a larger study about binge eating among sexual minority and heterosexual young women, in which data are collected entirely remotely. Methods: Sexual minority (n=12) and heterosexual (n=9) women ages 18-30 who binge ate took part in a pilot EMA study and exit interview and survey. As part of the consent and orientation process, participants reviewed video and written materials describing the study purpose and procedures. Using a smartphone app, for seven consecutive days they completed a survey each morning, 5 random surveys per day, and self-initiated a survey each time they binge ate. Participants then provided feedback on the study via a 1-hour virtual interview and online survey. Interviews were transcribed and reviewed by two coders to identify themes on the acceptability and feasibility of the EMA procedures with a focus on: (I) the training and study description materials; (II) general smartphone app and survey preferences; and (III) specific EMA survey question content and wording. Results: The qualitative and quantitative data converged to suggest participants were able to easily download and use the app to complete surveys and report on binge eating events. Participants provided feedback that was incorporated into revisions on general study procedures, the training video content, and EMA question content for binge eating, identity-related stressors, and appearance-related pressures. No systematic themes in the quantitative or qualitative data emerged to suggest questions were perceived differently by sexual minority and heterosexual young women. Conclusions: These findings provide evidence for the feasibility of conducting a remote EMA study to assess young women's experiences around binge eating. This formative study provides an example of how a mixed methods approach can be used to refine EMA study methods and questions to improve study design.

Weight Bias Internalization and Psychosocial, Physical, and Behavioral Health: A Meta-Analysis of Cross-Sectional and Prospective Associations.

Coinciding with widespread efforts to address obesity, weight bias internalization (a process of self-devaluation wherein individuals apply weight-biased stereotypes to themselves) has gained increased attention as a robust correlate of poor health outcomes. The present meta-analysis aimed to provide the largest quantitative synthesis of associations between weight bias internalization and health-related correlates. Studies that provided zero-order correlations for cross-sectional or prospective associations between weight bias internalization and physical, psychosocial, and behavioral health correlates were included in the meta-analysis. Meta-regression determined whether these associations differed based on demographic (sex/gender, race, age), anthropometric (body mass index), and study-level (publication status, sample type, study quality) moderators. Data for 149 (sub)samples were identified that included between 14 and 18,766 participants (M sample size = 534.96, SD = 1,914.43; M age = 34.73, SD = 12.61, range = 9.95-65.70). Results indicated that greater weight bias internalization was concurrently associated with worse psychosocial (e.g., negative and positive mental health, social functioning), physical (e.g., BMI, weight maintenance, health-related quality of life [HRQoL]), and behavioral health (e.g., disordered eating behaviors, healthy eating, physical activity) across most constructs, with effects ranging from small to very large in magnitude. Preliminary evidence also suggested that greater weight bias internalization was subsequently associated with less weight loss and increased negative mental health. Notable variations in the nature and magnitude of these associations were identified based on the health-related correlate and moderator under consideration. These findings indicate that weight bias internalization is linked to multiple adverse health-related outcomes and provide insight into priorities for future research, theory building, and interventions in this area.

Perceived Stress, Religiosity, and Substance Use Among African American and Latinx College Students with Asthma in the USA.

This study examined associations among perceived stress, religiosity, and substance use in African American and Latinx college students with asthma. Participants included 194 college students with asthma (18-20 years, 63.4% African American, 21.1% Latinx). Eligible students completed an online questionnaire that included measures of asthma control, perceived stress, religiosity, alcohol misuse, and last 30-day tobacco use and marijuana use. Over one-quarter (25.3%) of participants reported using tobacco and 31.9% reported using marijuana in the past 30 days. Perceived stress and religiosity were each independently associated with multiple indicators of substance use. Asthma control moderated associations between religiosity and tobacco use in the past 30 days (b = - .014, p = .002), such that the association between religiosity and tobacco use was stronger among those with better asthma control. Participant gender significantly moderated the association between perceived stress and alcohol misuse (b = - .099, p = .029); a stronger, positive association between stress and alcohol misuse was found among men. Students' perceived stress levels were associated with marijuana use in the past 30 days and high alcohol misuse. Religiosity was inversely linked to substance use. There is a need for healthcare providers to recognize and focus on substance use prevention specifically among African American and Latinx college students with asthma.

Gender, sexual orientation, and mental health in the kink community: an application of coping self-efficacy theory.

OBJECTIVE: This paper advances understanding of the kink community by examining mental health and coping-self efficacy (CSE) variation by gender and sexual orientation. DESIGN: Adult members of the National Coalition for Sexual Freedom (N = 332) completed an online cross-sectional health assessment. MAIN OUTCOME MEASURES: The assessment included the Coping Self-Efficacy (CSE) Scale; Depression and Anxiety Stress Scale-21; and Alcohol Use Disorders Identification Test. RESULTS: Transgender and non-binary persons reported consistently low coping beliefs and poor mental health. Queer sexual minority persons reported low CSE thought stopping and high anxiety. Several CSE thought stopping moderation effects on mental health were observed. CONCLUSIONS: Findings may inform clinical implications, as bolstering coping-related beliefs and skills via cognitive-behavioral therapy may offer mental health benefit to kink practitioners.

Daily weight stigma experiences, and disordered and intuitive eating behaviors among young adults with body dissatisfaction.

OBJECTIVE: The present study aimed to extend naturalistic weight stigma research by examining the following aims among young adults with body dissatisfaction and varied body mass indices (BMIs): (1) characterize the frequency of individuals' daily weight stigma experiences, and contextual variations, over a 14-day period; (2) examine whether BMI moderated daily associations between weight stigma experiences relative to eating disorder symptoms and intuitive eating behaviors. METHOD: Women (n = 174) and men (n = 24) completed a 14-day daily diary protocol. Concurrent and time-lagged multilevel models examined associations between daily weight stigma, and eating disorder and intuitive eating behaviors among women only due to the small subsample of men. RESULTS: Over the 14-day assessment, 43.94% (n = 87) of participants experienced weight stigma. Weight stigma rates varied based on how, where, and by whom weight stigma was expressed, and via BMI. Further, among women, multiple concurrent within-person associations were identified between women's daily weight stigma experiences and daily eating disorder symptoms (skipping meals, binge eating, and body dissatisfaction). Time-lagged associations also showed that women's weight stigma experiences on a given day were associated with a greater likelihood that they would limit the amount of food they consumed the next day. These associations did not differ via women's BMIs. DISCUSSION: Collectively, these findings provide important information on how weight stigma experiences unfold in daily life among individuals with body dissatisfaction and varied BMIs, and the proximal and more enduring impact of women's daily weight stigma experiences on their use of multiple adverse eating behaviors that can promote poor health. PUBLIC SIGNIFICANCE: The present findings provide important information on how, where, and by whom weight stigma experiences unfold in daily life among young adults with body dissatisfaction and varied body weights, as well as the proximal and more enduring impact of women's daily weight stigma experiences on their use of a variety of adverse eating behaviors that can promote poor health.

Criterion Validity of Protective Behavioral Strategies for Alcohol Consumption among College Students: Comparison across Two Measures.

BACKGROUND: Protective behavioral strategies (PBS), or behaviors used to reduce harm associated with alcohol use, are often associated with lower levels of alcohol consumption, lower engagement in high-risk drinking behaviors, and fewer alcohol-related consequences. Although the majority of studies have found significant associations between higher PBS use and lower consumption or consequences, some studies have found nonsignificant or even positive associations. One explanatory hypothesis is that the mixed findings are due to differential content in PBS measures. OBJECTIVES: The current study examined the criterion validity of two widely-used PBS measures, the PBSS and the SQ. In a multi-institution online study assessing alcohol outcomes, college drinkers were randomly assigned to complete one PBS measure. Both measures had the same response options to standardize assessment and focus on content. RESULTS: Findings suggest both measures of PBS are consistently predictive of alcohol outcomes among college drinkers, across multiple subpopulations (i.e., strength of association was not moderated by sex, race, or drinking level). CONCLUSIONS/IMPORTANCE: Some PBS subscales were more impactful than others, suggesting researchers may want to choose which PBS scale to use based on outcomes of interest, or after determining if alternatives to drinking is an important facet of PBS for the research questions being examined. Moreover, the differential findings for subscales suggest that prevention and intervention programs incorporating PBS should focus on strategies that avoid high-risk scenarios (e.g., avoiding shots or drinking games), rather than general strategies of self-pacing.

Emotion word use patterns and eating disorder symptoms: Considering the circumplex model of affect and basic emotions theory.

OBJECTIVE: No prior research has examined whether the types of emotion words individuals use to describe their affective experiences cluster along affective dimensions inherent within leading affect theories, or how such emotion word use maps onto eating disorder (ED) symptoms. METHOD: To address these gaps, latent profile analysis was used to empirically-identify groups of young adults (N = 352) by how often they use emotion words characterized by the circumplex model of affect's valence-arousal dimensions and basic emotions theory's basic versus complex emotion word categorizations. Auxiliary analyses examined differences in groups' ED symptoms (binge eating, purging, restricting, excessive exercising, muscle building, body dissatisfaction, and cognitive restraint). RESULTS: The 5-profile valence-arousal model and 4-profile basic-complex model were the best-fitting theoretically-supported solutions. Valence-arousal profiles with greater negative affect valence generally exhibited worse ED pathology than others, whereas profiles with greater positive affect valence produced inconsistent risk- and protective-factor relations with distinct ED symptoms. Basic-complex profiles characterized by frequent use of both basic and complex emotion words generally had the greatest ED severity, and profiles with greater basic emotion word use exhibited elevated binge eating. DISCUSSION: Individual-differences in young adults' emotion word use patterns, versus sample-level averages only, warrant further consideration in ED prevention and research. PUBLIC SIGNIFICANCE: The present findings suggest that young adults differ in the types of words they use to describe their emotional experiences, and that these unique emotion word use patterns are linked to distinct eating disorder symptoms. These sources of variation warrant further consideration in eating disorders prevention efforts and future research seeking to advance affect-based eating disorders theories.

Recruiting Cisgender Female Couples for Health Disparity-Focused Daily Diary Research: Challenges, Successes, and Lessons Learned.

The underlying mechanisms of sexual minority women's (SMW's) numerous physical and mental health disparities compared to heterosexual women are not well understood. The contribution of relationship factors is particularly understudied; few studies collect data from both same-sex female partners. Further, most research among SMW is cross sectional which limits our understanding of day-to-day experiences of same-sex women's couples. This paper aimed to describe the feasibility of recruiting a large sample of SMW and their female partners for a disparity-focused daily diary study investigating alcohol use and mental health. A firm specializing in sexual minority market research was enlisted to help with recruitment from multiple sources and conducted an initial pre-screening of SMW and their female partners, at least one of whom drank alcohol regularly. A total of 4182 individuals completed the pre-screener, with information for 930 individuals (465 couples) being sent to the research team. From this, 376 individuals (188 couples) completed the study screener, met the inclusion criteria, and were invited to participate. Ultimately, 326 individuals (163 couples) consented and completed baseline. A total of 321 individuals, from 162 couples, began the daily diary portion of the study. Compliance with study procedures was excellent. The use of multiple recruitment sources increased the diversity of the sample. Challenges to recruitment, changes in protocol, and characteristics of the final sample are discussed.

Rationale and Design of an Ecological Momentary Assessment Study Examining Predictors of Binge Eating Among Sexual Minority and Heterosexual Young Women: Protocol for the Health and Experiences in Real Life (HER Life) Study.

BACKGROUND: Previous research has identified health disparities between sexual minority and heterosexual women, including increased rates of obesity and binge eating in sexual minority women. Established predictors of binge eating behavior include negative emotions and sociocultural processes; however, these studies are generally conducted in samples of young women where sexual identity is not known or reported. There is a dearth of research evaluating how sexual minority-specific factors (eg, minority stress and connectedness to the lesbian, gay, bisexual, transgender, and queer community) may affect binge eating in sexual minority women. In addition, no studies have examined these processes in racially diverse samples or considered how intersecting minority identities (eg, Black and sexual minority) may affect eating behaviors. OBJECTIVE: The Health and Experiences in Real Life (HER Life) Project aims to clarify real-world predictors of binge eating in young heterosexual and sexual minority women using ecological momentary assessment. The role of affective, social, and health behavior factors in binge eating will be examined for all women (aim 1), and sexual minority-specific predictors will also be considered for sexual minority women participants (aim 2). Person-level moderators of race, body- and eating-related factors, and sexual minority-specific factors will also be examined to better understand how real-world binge eating predictors may differ for various demographic groups (aim 3). METHODS: Researchers aim to recruit 150 sexual minority and 150 heterosexual women from across the United States, including at least 50 Black women for each group, using web-based recruitment methods. The eligibility criteria include identifying as a woman, being aged between 18 and 30 years, and having had at least two binge eating episodes in the last 2 weeks. Participants must endorse being only or mostly attracted to men (considered heterosexual) or only or mostly attracted to women or having a current or most recent female partner (considered sexual minority). Eligible participants complete an initial web-based baseline survey and then 14 days of ecological momentary assessment involving the completion of a morning and before-bed survey and 5 prompted surveys per day as well as a user-initiated survey after binge eating episodes. The data will be analyzed using a series of multilevel models. RESULTS: Data collection started in February 2021. We have currently enrolled 129 sexual minority women and 146 heterosexual women. Data collection is expected to conclude in fall 2022. CONCLUSIONS: The Health and Experiences in Real Life Project aims to elucidate potential differences between sexual minority and heterosexual women in within-person factors predicting binge eating and inform eating disorder interventions for sexual minority women. The challenges in recruiting sexual minority women, including the determination of eligibility criteria and considerations for remote data collection, are discussed. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/41199.

Parent-adolescent dyadic associations among weight misperceptions, weight change behaviors, and dietary intakes.

Prior research has shown that larger differences between individuals' actual and perceived bodily states are associated with their engagement in weight change behaviors. However, it remains unknown whether these intrapersonal associations extend to the parent-adolescent dyadic level. To address this research gap, the present study examined associations between parents' and adolescents' weight misperceptions (discrepancies between individuals' self-reported body mass indices and perceived weight statuses) relative to participants' own and their dyadic partners' weight change behaviors and dietary intakes. Participants included a large community sample of parent-adolescent dyads (N = 1,606 dyads) who completed the National Cancer Institute's FLASHE Study. Actor-partner interdependence models examined dyadic associations among participants' weight misperceptions (over- and under-perceptions) relative to their own and their dyadic partners' general weight change behaviors (current weight loss and gain behaviors), and low nutrient (e.g., processed foods) and nutrient-dense (e.g., fruits/vegetables) dietary intakes. Multiple intrapersonal and cross-dyad member associations were identified that varied based on the direction of weight misperceptions, the weight control behavior type, and whether the dyadic member was a parent or adolescent. For example, adolescents' weight under-perception was associated with a lower likelihood of their own, but not their parents', current weight loss behavior use, whereas parents who exhibited weight under-perception were less likely to report weight loss behaviors at the intrapersonal level and were less likely to have adolescents who reported weight loss behaviors. These results suggest that associations among weight misperceptions and weight control behaviors within the parent-adolescent dyadic context are complex, and that both inter- and intra-individual processes are implicated in these associations. The impact of these perceptual influences on parent-adolescent dyads' use of both healthy and disordered eating behaviors warrants further exploration in future research.

A meta-analysis of associations between weight bias internalization and conceptually-related correlates: A step towards improving construct validity.

Weight bias internalization (WBI), a process of weight-based self-devaluation, has been associated with adverse mental and physical health. However, there are limitations with the existing conceptualization and operationalization of WBI that raise questions about the implications of this evidence-base. To address these limitations, the present study investigated the construct validity of WBI by conducting a meta-analysis of associations between WBI (as currently operationalized) and conceptually-related correlates. Studies identified through October 2021 that provided zero-order correlations for associations between WBI and conceptually-related constructs were examined. Meta-regression determined whether these associations differed across WBI measures and demographic (age, sex/gender, race, BMI) and study-level (publication status, sample type, study quality) moderators. Data for 128 (sub)samples were identified (Msample size = 477.83, SD = 1679.90; Mage = 34.46, SD = 12.17; range = 10.21-56.60). Greater WBI exhibited large to very large associations with factors suggested to have considerable overlap with this construct (negative and positive body image, self-devaluation), general and weight-specific experiential avoidance, and individuals' anticipation of future weight stigma. Associations varied for other constructs that have been differentially included in conceptualizations of WBI (endorsing weight bias, weight stigma stereotype awareness, weight stigma experiences), and via measurement-related, demographic, and study-level factors. These findings provide important information that can advance WBI conceptualization and measure-refinement.

Examining Race and Gender Differences in Associations Among Body Appreciation, Eudaimonic Psychological Well-Being, and Intuitive Eating and Exercising.

PURPOSE: The present study examined race and gender differences among positive psychological constructs, and adaptive eating and exercise behaviors. DESIGN: Cross-sectional. SETTING: Online. SAMPLE: College students (N = 1,228; Mage = 22.27, SD = 5.83). MEASURES: Participants completed measures assessing positive body image, eudaimonic psychological well-being, and health behaviors. ANALYSES: Multi-group structural equation modeling was used to examine whether White versus Black race and, separately, woman versus man gender identity moderated associations among body appreciation, eudaimonic psychological well-being, and intuitive eating and intuitive exercising. RESULTS: Results generally indicated that greater body appreciation was associated with greater eudaimonic psychological well-being (ßs = 0.48, 0.56) and, in turn, intuitive eating (ßs = -0.20, 0.25) and intuitive exercising (ßs = -0.06, 0.23). However, notable variations in this pattern of results were identified based on the facet of intuitive eating and exercising under investigation, and participants' racial identities. For example, greater eudaimonic psychological well-being strictly mediated a positive association between body appreciation and reliance on hunger and satiety cues intuitive eating behaviors among participants who identified as Black (95%CI: 0.01, 0.12), but not White (95%CI: -0.08, 0.04). CONCLUSIONS: Although the present findings warrant replication using longitudinal designs due to the cross-sectional nature of the present study, these findings suggest that increasing adults' eudaimonic psychological well-being may help improve health-promoting eating and exercise behaviors, and should be assessed as a mechanism of change in future clinical research.

Family meals, positive versus negative emotion suppression, and emotional eating: examining adolescent-parent dyadic associations.

PURPOSE: The present study aimed to extend existing research by examining adolescent-parent dyadic associations among adaptive and maladaptive family meal characteristics, positive and negative emotion suppression, and emotional eating. METHOD: Participants included a community-based sample of adolescents and parents (N = 1646 dyads) who participated in the National Cancer Institute's Family Life, Activity, Sun, Health, and Eating Study. Dyad members both completed measures assessing family meal characteristics (family meal importance beliefs, family mealtime television watching), emotion suppression, and emotional eating via online surveys. Actor-partner interdependence models were used to examine dyadic associations among the assessed family meal characteristics, positive and negative emotion suppression, and emotional eating. RESULTS: Multiple within-person (e.g., adolescent-adolescent, parent-parent), cross-dyad member (e.g., adolescent-parent, parent-adolescent), and divergent adolescent versus parent dyadic effects were identified that differed based on the extent to which participants suppressed positive versus negative affect. For example, whereas adolescents' stronger beliefs in the importance of frequent family meals were associated with lower levels of their own suppression of positive emotions and, in turn, lower levels of both their own and their parents' emotional eating, these mediational associations were only identified at the within-person (not cross-dyad member) level among parents. CONCLUSIONS: Collectively, these findings attest to the complexity of associations among the assessed risk and protective family meal characteristics, the suppression of differentially valenced emotions, and emotional eating that manifest at the adolescent-parent dyadic level. Findings also support the continued use of a family-based perspective to further the understanding of factors that are associated with emotional eating. LEVEL OF EVIDENCE: Level V, cross-sectional descriptive study.

Development and initial validation of an underreporting of Disordered Eating Behaviors Scale.

The purpose of this study was to develop the Underreporting of Disordered Eating Behaviors Scale (UDEBS) to detect attempts by respondents to underreport eating patterns that reflect symptoms of an eating disorder. In "Study 1", the scale and validity measures were administered via an online survey to 692 undergraduates. In "Study 2", these measures were administered to 810 undergraduates using a simulation design where participants were randomized to four conditions: (1) answering as truthfully as possible, or as if they are trying to hide (2) Binge Eating Disorder (BED), (3) Anorexia Nervosa (AN), or (4) Bulimia Nervosa (BN). "Study 1" results suggested that men and women have divergent UDEBS distributions and item endorsement rates; therefore, separate analyses were performed by gender. Individuals who scored above one standard deviation (SD) on the UDEBS reported less body dissatisfaction and disordered eating (ps < 0.05) than those who scored one SD below. In "Study 2" women who were instructed to hide an eating disorder reported significantly higher UDEBS scores than women instructed to answer truthfully. There were no significant differences between conditions for men. The final 15-item scale indicated that women who complied with instructions to underreport produced scores 1.45 (BN) to 1.72 (AN) times greater than the truthful responding condition. This novel scale can potentially assist in detecting women who underreport in relation to disordered eating, which may be useful in research and clinical contexts where underreporting is a concern. Future research is needed with men and clinical samples.Level I Evidence obtained from an experimental study.

Associations between body dissatisfaction and relationship functioning among same-sex female couples: An actor-partner interdependence model.

Nearly all past research about body dissatisfaction and romantic relationship factors is among heterosexual couples; little is known about these associations in sexual minority couples. The present study aimed to fill gaps in the current literature by using actor-partner interdependence models (APIMs) to examine dyadic patterns of association between body dissatisfaction and different aspects of relationship functioning among same-sex female couples. Participants were 163 same-sex female romantic dyads (326 women) between the ages of 18-35 years who completed measures of body dissatisfaction and relationship factors. Results from significance testing of actor and partner effects indicated higher levels of women's own body dissatisfaction were associated with lower levels of their own, but not their partner's, relationship satisfaction, closeness, sexual satisfaction, and intimacy/connectedness. Significance testing alone indicated that the association between one's own body dissatisfaction and their partner's relationship satisfaction was not significant. However, dyadic pattern testing identified a partner pattern for this effect, which suggests that the association between one's own body dissatisfaction and one's own relationship satisfaction is similar in magnitude and direction as that between an individuals' own body dissatisfaction and their partner's relationship satisfaction. In this study, women's own body dissatisfaction was found to be negatively associated with their own relationship functioning, which is consistent with findings of women in male-female couples. Thus, these findings highlight the important role that body dissatisfaction plays in women's relationship experiences. More research is needed to better understand potential cross-partner effects of body dissatisfaction and relationship factors in same-sex female couples. (PsycInfo Database Record (c) 2022 APA, all rights reserved).