Risk and resilience in eating disorders: differentiating pathways among psychosocial predictors.

OBJECTIVE: Eating disorders (EDs) represent a rising global health concern. The current study takes a multivariate approach to examine psychological (i.e., perfectionism, anxiety sensitivity [AS], emotion dysregulation) and sociocultural factors (i.e., body dissatisfaction) that may relate to risk and resilience in EDs. METHODS: Participants were 698 undergraduate students (Mage = 21, SDage = 4.02), mainly female (71%) and Hispanic (61.6%), who participated in an online survey assessing perfectionism, emotion dysregulation, AS, body dissatisfaction, and eating behaviors. RESULTS: The results from structural equation model analyses revealed differential associations with disordered eating (DE) outcomes. Self-oriented perfectionism and dysmorphic appearance concerns were associated with increased dieting/carb restriction, desire for thinness, and binging tendencies. Specifically, emotional nonacceptance and lack of emotional awareness showed associations with elevated risk for dieting/carb restriction and purging tendencies, respectively. Conversely, lack of emotional clarity showed a protective pathway to these risk behaviors. Anxiety sensitivity cognitive concerns related to higher purging tendencies, while AS social concerns related to lower purging and binging tendencies. DISCUSSION: Findings highlight the differential pathways of psychosocial risk and resilience for EDs. Subscales of emotional dysregulation and AS showed risk as well as resilience associations with DE outcomes. This information is key for advancing transdiagnostic prevention and intervention to reduce the rising rates of EDs.

Eating disorders are rising worldwide at alarming rates. We know their development is complex involving multiple factors, but the specific contributions of different factors are not well understood. This study demonstrates differential pathways of risk and resilience among psychosocial factors (i.e., perfectionism, emotion dysregulation, anxiety sensitivity, and body dissatisfaction) and eating behaviors and cognitions. Facets of perfectionism and body dissatisfaction were associated with unhealthy eating behaviors like dieting and bingeing. However, different aspects of emotional dysregulation and anxiety sensitivity were linked to maladaptive eating behaviors, but others seemed to protect against risky eating behaviors. This information is crucial for creating more effective prevention and treatment strategies for eating disorders.

Validation and measurement invariance of the Compulsive Exercise Test among Brazilian and American young adults.

PURPOSE: To evaluate compulsive exercise, researchers often rely on the widely used Compulsive Exercise Test (CET). However, the measure has shown unstable factor structure in several validation studies and is not available in Portuguese for use in Brazil. We aimed to describe the translation and cultural adaptation of the CET to Brazilian Portuguese, to test several factor structures among Brazilian and US samples of men and women, to test measurement invariance across countries, and to evaluate its internal consistency. Furthermore, we sought to evaluate convergent validity, correlating the CET with a measure of eating disorder symptoms, and to compare compulsive exercise symptoms between countries. METHODS: Four models of the latent structure of the CET were tested using confirmatory factor analyses (CFAs), three-factor structure with 15 items, three-factor structure with 18 items, four-factor structure with 21 items, and the original five-factor structure with 24 items, in a sample of 1,531 young adults (601 Brazilians and 930 Americans), aged 18-35 years. RESULTS: A series of CFAs demonstrated that the three-factor structure with 15 items showed a better fit to the data. This model demonstrated good convergent validity and internal consistency. Results from the CET multigroup CFA showed evidence for the invariance at the configural, metric, and scalar levels across Brazilians and Americans. Furthermore, significant differences were found between Brazilians and Americans, with Brazilians demonstrating higher scores on the Avoidance and rule-driven behavior and Mood improvement subscales, whereas US participants scored higher on the Weight control exercise subscale. CONCLUSIONS: Results support the three-factor structure with 15 items to be used as a measure of compulsive exercise among Brazilians and Americans, allowing cross-cultural comparisons between these countries. LEVEL OF EVIDENCE: Level V, Cross-sectional, Psychometric study.

Beyond generalized anxiety: the association of anxiety sensitivity with disordered eating.

BACKGROUND: Anxiety and eating disorders (EDs) are rising at alarming rates. These mental health disorders are often comorbid, yet the factors associated with their comorbidity are not well understood. The present study examined a theoretical model of the pathways and relative associations of anxiety sensitivity (AS) with different dimensions of ED risk, controlling for generalized anxiety. METHODS: Participants (N = 795) were undergraduate students with an average age of 21 (SD = 4.02), predominantly female (71%), and Hispanic (71.8%). Participants completed an online survey with established measures of AS (i.e., Anxiety Sensitivity Index-3; ASI-3), general anxiety (i.e., Beck Anxiety Inventory; BAI), and eating behaviors (i.e., Eating Attitudes Test-26; EAT-26). RESULTS: The results of our structural equation models indicated that AS subscales were significantly associated with dimensions of the EAT-26, even when controlling for generalized anxiety. Specifically, the ASI-3 factors reflecting cognitive and social concerns provided the most consistent significant associations with EDs. Whereas reporting higher cognitive concerns was associated with higher ED symptoms (e.g., reporting the urge to vomit after a meal), reporting higher social concerns was associated with fewer ED symptoms. These differential results may suggest risk and resilience pathways and potential protective or buffering effects of social concerns on ED risk. DISCUSSION: Findings advance understanding of the role of AS in the comorbidity of anxiety and EDs, demonstrating the strong association of AS with ED pathology. These findings provide cognitive indicators for transdiagnostic therapeutic intervention in order to reduce the risk of EDs.

Many people with anxiety disorders also have high rates of eating pathology, and vice versa. Teasing apart the factors that may contribute to this co-morbidity can provide important information for psychotherapeutic prevention and intervention. In this study we examine the contributions of anxiety sensitivity, also known as the 'fear of fear,' beyond that of generalized anxiety in its associations with eating disorder outcomes. Our findings show that the cognitive concerns of anxiety (i.e., thinking about being anxious) are associated with higher urges to purge after eating. Higher social concerns with anxiety (i.e., concerns that others will know one is anxious) related to fewer symptoms of eating disorders. Taken together our findings illuminate that considering anxiety sensitivity may be helpful for the diagnosis and treatment of eating disorders.

Relationships among adult playfulness, stress, and coping during the COVID-19 pandemic.

The COVID-19 pandemic created high levels of stress that negatively affect mental health and well-being. The stress and coping process is influenced by individual difference factors, such as personality, that impact perceptual processes and emotional reactions. Adult playfulness is a personality characteristic that may lead to better mental and physical health outcomes. We test a theoretical model to determine whether the two factors of perceived stress, perceived self-efficacy (PSE) and perceived helplessness (PH), mediate the relationship among playfulness and coping in adults (N = 694). Scores on the Perceived Stress Scale were high indicating high levels of pandemic-related stress. The SEM model demonstrated direct effects of playfulness on PSE, PH, adaptive, maladaptive, and supportive coping. Both dimensions of perceived stress were partial mediators in the relationship among playfulness and coping outcomes. Findings illustrate the pathways by which adult playfulness can amplify or attenuate the impact of stress perceptions on coping strategies. The importance of building psychological resources such as playfulness to boost adaptive outcomes in stressful situations such as the COVID-19 pandemic is discussed. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12144-022-02870-0.

The MAPS model of self-regulation: Integrating metacognition, agency, and possible selves.

Self-regulation, a social-cognitive process at the intersection of metacognition, motivation, and behavior, encompasses how people conceptualize, strive for, and accomplish their goals. Self-regulation is critical for behavioral change regardless of the context. Research indicates that self-regulation is learned. Integral to successful self-regulation of behavior are: (a) an articulated concept of one's possible selves, (b) metacognitive knowledge and effective strategies, and (c) a sense of one's own agency. We present the theoretical linkages, research evidence, and applied utility for these three components in promoting self-regulation of behavior, specifically in the domain of learning. We propose the MAPS model to account for the pathways of influence that lead to behavioral change. This model illustrates the dynamic and feed-forward processes that derive from the interactions among possible selves, metacognition, and agency to provide the context for developing self-regulated and effective learning that promotes student success, the transfer of knowledge, and the foundation for life-long learning.

Psychometric properties of the intuitive eating scale-2 (IES-2) in a culturally diverse Hispanic American sample.

BACKGROUND: Intuitive eating is an adaptive eating tendency consistently associated with positive physical and mental health outcomes, including lower risk for obesity and eating disorders (EDs). Obesity rates are disproportionately high in Hispanic American populations, yet the properties of intuitive eating remain to be examined in such samples. METHOD: The current study examined the psychometric properties of the Intuitive Eating Scale-2 (IES-2) in a Hispanic American sample of adult college students (N=482), and related IES-2 scores to levels of disordered eating, body mass index (BMI), fruit and vegetable consumption, and body shape satisfaction. RESULTS: The final confirmatory factor analysis supported a three factor, 11 item measure with the subscales of Eating for Physical Rather Than Emotional Reasons, Reliance on Hunger and Satiety Cues, and Body Food Choice Congruence. The Unconditional Permission to Eat subscale could not be replicated in the current sample. As predicted, scores on the revised measure differed by BMI category and body shape satisfaction, and correlated with disordered eating tendencies and fruit and vegetable consumption. CONCLUSION: The current findings demonstrate that the modified IES-2 is better tailored to assess the cultural nuances influencing intuitive eating and can advance understanding how intuitive eating is understood and practiced in Hispanic Americans, compared to the original measure.

Body Dissatisfaction in Early Adolescence: The Coactive Roles of Cognitive and Sociocultural Factors.

The sociocultural influences of the media, friends, and family on body dissatisfaction in young girls are well documented, yet further increasing our comprehension of the coaction of cognitive processes with sociocultural factors is crucial to understanding the dynamic emergence of body dissatisfaction in early adolescence. The current study examined the roles of appearance related messages and expectations from friends and family and selective attention biases in the development of body dissatisfaction. An ethnically and racially diverse sample of girls (72 % Hispanic White, 17.8 % African-American, 8.5 % non-Hispanic White, and 1.7 % Asian-American) between the ages of 9 and 13 (N = 118) completed multiple measures of attention, sociocultural attitudes toward weight and shape, and body dissatisfaction. The data from these measures were examined using path analysis. The final model fit well, and demonstrated the coactive effect of selective attention and sociocultural factors on body dissatisfaction. These findings will be instrumental in designing future body dissatisfaction intervention and prevention programs that incorporate cognitive factors, augmenting the existing sociocultural and psycho-educational frameworks.

Self-esteem, diet self-efficacy, body mass index, and eating disorders: modeling effects in an ethnically diverse sample.

PURPOSE: Disordered eating patterns, particularly binge eating, are prevalent in Hispanic samples, yet the biopsychosocial risk factors remain understudied in minority populations. The relationship between diet self-efficacy and bulimic symptoms has been established in non-Hispanic white samples but not yet in Hispanics. This study sought to identify the direct role of diet self-efficacy on eating disorder risk and symptomology in a multicultural Hispanic sample, and to investigate the potential indirect relations among diet self-efficacy, self-esteem, body mass index (BMI), and eating disorder risk and symptomology in Hispanics and non-Hispanic whites. METHODS: The present study surveyed 1339 college students from diverse ethnic backgrounds. Participants completed four standardized scales to assess acculturation, diet self-efficacy, global self-esteem, and eating disorder symptomology and risk. Self-reported height and weight were used for BMI calculations, and the data were analyzed in a robust maximum-likelihood structural equation modeling (SEM) framework. RESULTS: The findings highlighted diet self-efficacy as a predictor of eating disorder risk and symptomology. Diet self-efficacy partially explained the covariation between self-esteem and eating disorder risk and symptomology, and between BMI and eating disorder risk and symptomology for the entire sample. CONCLUSION: Diet self-efficacy emerged as an important construct to consider in developing eating disorder prevention and treatment models.

Self-regulation and eudaimonic well-being across adulthood.

UNLABELLED: BACKGROUND/STUDY CONTEXT: The authors developed and tested a model to examine the developmental self-regulatory pathways that lead to optimal eudaimonic well-being across adulthood. METHODS: Measures of goal adjustment, optimization, possible selves, and well-being were obtained from 590 adults ranging in age from 17 to 94. Structural equation modeling was used to determine the whether there were age-differential pathways among the developmental self-regulatory processes and well-being. RESULTS: The model predicts interactions among age, hoped-for possible selves, age-sensitive developmental processes (i.e., goal adjustment, optimization), and psychological well-being. Results showed direct effects of goal adjustment on well-being and indirect effects of goal adjustment and optimization on well-being through hoped-for possible selves. There were significant age differences in the indirect effects of goal adjustment on possible selves and well-being, such that, by age 55, these pathways disappear, and the role of future self-representations diminish. CONCLUSIONS: Findings indicate that the role of possible selves in regulating self-motivated development changes across the adult life span.

Psychosocial outcomes in later life: a multivariate model.

A conceptual model was developed to identify developmental self-regulatory pathways to optimal psychosocial outcomes in adulthood. The model delineates influences among age, possible selves, developmental processes (i.e., coping, control), and well-being. Results showed age effects on all constructs except selective control. Three consistently common predictors of well-being (i.e., goal pursuit, goal adjustment, and optimization) emerged. The effects of age on well-being were differentially mediated by developmental processes. Specifically, negative age-related changes in offensive processes (i.e., goal attainment) were offset by positive influences of defensive processes (i.e., goal adjustment), which had the net effect of preserving well-being. The model demonstrates a more optimistic pattern of aging in which gains offset losses leading to positive outcomes and highlights the importance of examining both independent and combined influences of age, self, and developmental processes on psychosocial outcomes.

Event memory and misinformation effects in a gorilla (Gorilla gorilla gorilla).

Event memory and misinformation effects were examined in an adult male gorilla ( Gorilla gorilla gorilla). The gorilla witnessed a series of unique events, involving a familiar person engaging in a novel behavior (experiment 1), a novel person engaging in a novel behavior (experiment 2), or the presentation of a novel object (experiment 3). Following a 5- to 10-min retention interval, a tester gave the gorilla three photographs mounted on wooden cards: a photograph depicting the correct person or object and two distractor photographs drawn from the same class. The gorilla responded by returning a photograph. If correct, he was reinforced with food. Across three experiments, the gorilla performed significantly above chance at recognizing the target photograph. In experiment 4, the gorilla showed at-chance performance when the event was followed by misinformation (a class-consistent, but incorrect photograph), but significantly above-chance performance when no misinformation occurred (either correct photograph or no photograph). Although the familiarity can account for these data, they are also consistent with an episodic-memory interpretation.

Coping with anxiety in later life.

The goal of this study was to determine how older adults cope with three forms of anxiety, and potential avenues for applied interventions. Although the findings shed light on some interesting findings with potential psychosocial applications, several limitations need to be noted. First, this study was based on two assumptions. The assumption, based on earlier work (Carver et al., 1989; Lazarus & Folkman, 1984; Zeidner & Saklofske, 1996), that certain coping strategies are more effective than others, and an assumption of the direction of influence in which anxiety is a precursor of coping strategies. Because this was an exploratory study, the research questions did not directly test these assumptions. Second, this study is correlational in nature. Therefore, conclusions cannot be drawn about the causality of these associations. Third, as with any self-report data and self-selected sample, one needs to interpret the findings with caution. Similarly, for the purposes of the study, a non-clinical sample of older adults was examined using three distinct conceptualizations of anxiety. Suggestions for future research include: Replication of this study using a multidimensional measure of anxiety appropriate for clinical samples. A longitudinal replication of this study identifying patterns of coping that facilitate adjustment over time. Finally, a more general purpose of this study was to focus attention on a neglected issue in gerontology--the experience of anxietY in later life (Frazier & Waid, 1999; Gatz, 1995; Rabins, 1992; Shamoian, 1991; Sheikh, 1992; Smyer, 1995; Stanley & Beck, 1998), and, most importantly, the role of gerontological nurses in early assessment and intervention for successful treatment of anxiety in older adults.

Stability and change in patterns of coping with Parkinson's disease.

This study examined how Parkinson's disease patients cope with disease-related stressors over time. Of interest was whether patterns of coping would support a dispositional model of coping (i.e., stability) or a contextual model of coping (i.e., change). The influence of stability and change in coping on mental and physical health outcomes was also examined. As expected, results showed that as the disease progressed, severity and distress increased and quality of life decreased. There was no change overall in the symptoms perceived as most stressful or the coping strategies employed to manage them. However, stability within individuals was associated with poorer mental and physical outcomes, whereas change in coping strategies was associated with more optimal outcomes. Evidence supporting both models of coping was found, and the potential applications of these findings for psychosocial intervention are discussed.