Orthorexia nervosa versus healthy orthorexia: Anxiety, perfectionism, and mindfulness as risk and preventative factors of distress.

BACKGROUND: Orthorexia nervosa is a recently conceptualised pathological entity presenting as an obsessive focus on healthy eating with associated psychosocial impairment. AIMS: The present study investigated the differential associations between orthorexia nervosa and healthy orthorexia with distress and impairment. MATERIALS & METHODS: With a community sample (N = 268) multiple measures of orthorexia nervosa and health orthorexia were compared as explanatory variables in mediation structural equation modelling (SEM). Outcome variables assessed and investigated were psychological distress while demographic variables were controlled. The mediating roles of perfectionism and health anxiety on orthorexia nervosa were examined with further preventative mediation role of mindfulness on distress. RESULTS: Distinctive to other eating disorders, gender showed no significant effects on orthorexia nervosa and healthy orthorexia. Signalling measurement issues for this disorder, the different measures of orthorexia nervosa resulted in mixed findings regarding body mass index and age. Findings supported perfectionism and health anxiety as risk factors, as well as mindfulness acceptance as a preventative factor in both orthorexia nervosa and healthy orthorexia. Orthorexia nervosa and healthy orthorexia assessed by most measures, contrary to the expectations, had significant positive associations with psychological distress indicated by stress, anxiety, and depression. DISCUSSION & CONCLUSION: The complexity in differentiating orthorexia nervosa from healthy orthorexia calls for further investigation. This research effort should serve to substantiate the status of orthorexia nervosa as a distinct clinical disorder.

Self-compassionate reflective writing for affect regulation in Australian perinatal women.

The current study investigated the effect of a brief online self-compassionate reflective writing task on affect regulation in a sample of Australian perinatal women. Participants were 55 women (Mage = 35.47, SD = 3.79) who were pregnant (16.4%) and/or had an infant <24 months old (76.4%). State self-compassion, positive and negative affect, and future help-seeking behavior intentions were compared at pre- and post-intervention while controlling for trait self-compassion. Inductive thematic analysis was used to extract themes regarding why participants deemed the intervention helpful or unhelpful. As hypothesized, global state self-compassion and intention to engage in self-care behavior were higher, and negative affect was lower, immediately post-intervention relative to pre-intervention scores. Follow-up subscale analyses revealed that the mechanisms of the shift in state self-compassion scores were via reduced self-judgment and overidentification and increased common humanity. There was no significant change in positive affect or intention to engage in help-seeking behavior. Most participants (75%) indicated that the task was helpful with themes identified as written format, changed perspective, dedicating time to reflect, improved mood, and practicing self-kindness. Self-compassionate reflective writing may be a brief and accessible psychosocial approach with the potential to foster healthy emotion regulation and coping among perinatal women.

Moral, self-interested, and social motivation each predict compliance with social distancing rules: utilitarianism is an indirect positive predictor.

BACKGROUND: Social distancing rules have proven to be essential in reducing the spread of COVID-19. However, we can optimise these rules if we identify factors which predict compliance. Thus, in this study we investigated whether compliance with distancing rules is predicted by whether an individual is motivated by moral, self-interested, or social reasons. We also investigated the impact of an individual's utilitarian orientation both on compliance itself and on reasons for compliance. METHODS: Our sample consisted of 301 participants recruited from four US states - California, Oregon, Mississippi, and Alabama - who completed an anonymous online survey. Six vignettes describing hypothetical social distancing rules were developed for the study. Participants indicated (i) how likely they were to violate each hypothetical distancing rule, (ii) how morally wrong violating each rule would be, (iii) how much risk of contracting COVID-19 they would tolerate in order to violate each rule, and (iv) how much social condemnation they would tolerate in order to violate each rule. Based on these responses, we gauged each participant's overall degree of compliance with social distancing rules as well as the extent to which each participant's compliance is motivated by moral, self-interested, and social reasons. We also measured other variables that could affect compliance including personality, level of religiosity, and inclination to engage in utilitarian reasoning. Multiple regression and exploratory structural equation modelling were used to determine predictors of compliance with social distancing rules. RESULTS: We found that moral, self-interested, and social motivation each positively predicted compliance, with self-interested motivation being the strongest predictor. Furthermore, utilitarian orientation indirectly predicted compliance, with moral, self-interested, and social motivation as positive mediating factors. No controlled covariates (personality factors, religiosity, political orientation, or other background variables) predicted compliance. CONCLUSION: These findings have implications not only for the design of social distancing rules but also for efforts to ensure vaccine uptake. Governments need to consider how to harness moral, self-interested, and social motivation to promote compliance, perhaps by co-opting utilitarian reasoning, which positively influences these motivational forces.

Accuracy-sensitisation promotes the sharing of pro- (but not anti-) vaccine information.

OBJECTIVE: This study investigated (i) factors predicting the seeking and sharing of vaccinerelated information, and (ii) the effect of an accuracy-sensitisation prime on sharing intentions. Design:This was a preregistered online survey with 213 participants. Participants were randomly assigned to an intervention group (who were exposed to an accuracy-sensitisation prime) or a control group. DESIGN: This was a preregistered online survey with 213 participants. Participants were randomly assigned to an intervention group (who were exposed to an accuracy-sensitisation prime) or a control group. MAIN OUTCOME MEASURES: Measures included decision-making style, COVID-19 anxiety, and percentages of pro and anti-vaccine friends. We also measured preferences to seek pro or anti-vaccine-related information and sharing intentions with respect to this information. RESULTS: Compared with those seeking both pro and anti-vaccine information, participants seeking only pro-vaccine information had lower hypervigilance and buck-passing and higher COVID-19 anxiety. The likelihood of sharing anti-vaccine information was positively predicted by the percentage of one's anti-vaccine friends, the size of one's social network, and conservative political orientation. Conversely, the likelihood of sharing pro-vaccine information was positively predicted by the percentage of one's pro-vaccine friends, and liberal political orientation. Participants sensitised to accuracy were significantly more likely to share provaccine information; however, accuracy-sensitisation had no effect on anti-vaccine information sharing. CONCLUSIONS: Individuals who seek anti-vaccine information have a tendency towards disorganised and impulsive decision-making. Accuracy-sensitisation may prime people to internalise a norm promoting truth-sharing.

No one is immune to misinformation: An investigation of misinformation sharing by subscribers to a fact-checking newsletter.

Like other disease outbreaks, the COVID-19 pandemic has led to the rapid generation and dissemination of misinformation and fake news. We investigated whether subscribers to a fact checking newsletter (n = 1397) were willing to share possible misinformation, and whether predictors of possible misinformation sharing are the same as for general samples. We also investigated predictors of willingness to have a COVID-19 vaccine and found that although vaccine acceptance was high on average, it decreased as a function of lower belief in science and higher conspiracy mentality. We found that 24% of participants had shared possible misinformation and that this was predicted by a lower belief in science. Like general samples, our participants were typically motivated to share possible misinformation due to interest in the information, or to seek a second opinion about claim veracity. However, even if information is shared in good faith and not for the purpose of deceiving or misleading others, the spread of misinformation is nevertheless highly problematic. Exposure to misinformation engenders faulty beliefs in others and undermines efforts to curtail the spread of COVID-19 by reducing adherence to social distancing measures and increasing vaccine hesitancy.

Increased meaningful activity while social distancing dampens affectivity; mere busyness heightens it: Implications for well-being during COVID-19.

Social distancing measures have been implemented in many countries to limit the spread of COVID-19. Emerging literature reveals that fear of acquiring COVID-19 has detrimental psychological ramifications. However, it seems likely that social distancing will have a further negative impact on well-being. The focus of this study was therefore to investigate whether changes in behaviour as a result of social distancing would predict changes in well-being. Participants (n = 95) rated their level of well-being as it was both during social distancing and retrospectively one month before beginning social distancing. Participants also indicated how much time they spent engaged in various activities both during social distancing and one month before social distancing and nominated how important each of these activities was for them. These measures employed scales created specifically for the present study. In addition, participants completed the Big Five Inventory-2 Extra-Short Form and the nine-item version of the Personal Optimism and Self-Efficacy Optimism Scale. We found that affectivity-both positive and negative-decreased with increased engagement in meaningful activities and that affectivity increased with increased activity in general. While both sorts of activity appear to improve some aspects of well-being, it appears that meaningful activity regulates psychological homeostasis while busyness in general does not.

Bleeding Complications After Percutaneous Liver Biopsy: Do Subcapsular Lesions Pose a Higher Risk?

OBJECTIVE: The purpose of this study is to determine the incidence of moderate and severe bleeding complications after subcapsular liver mass biopsy and compare it with the incidences of such complications after nonsubcapsular liver mass biopsy and after random biopsy. MATERIALS AND METHODS: This retrospective review of ultrasound-guided liver biopsies was performed between January 2006 and February 2015. Biopsy type, needle size, the number of needle passes, and mass size and depth were recorded. A mass was categorized as subcapsular if it abutted the capsule and if the needle entered the mass directly without first traversing normal liver. Patients were observed postprocedurally, and the electronic medical record and findings from imaging performed within 1 month of the procedure were reviewed to assess for bleeding. Bleeding complications were categorized by size (with mild bleeding denoted by perihepatic blood ≤ 2 cm thick; moderate bleeding denoted by perihepatic blood > 2 cm thick, observation of blood elsewhere in the upper abdomen, or a combination of both findings; and severe bleeding denoted by blood extending into the lower abdomen, pelvis, or both). Bleeding rates were compared between groups using the Fisher exact test. RESULTS: Of a total of 1876 biopsies, 347 (18.5%) involved subcapsular masses, 760 (40.5%) involved nonsubcapsular masses, and 769 (41.0%) were random biopsies. There were no significant differences in biopsy type (p = 1.00), needle size (p = 0.12), or the number of needle passes (p = 0.10) when subcapsular and nonsubcapsular masses were compared. Thirteen moderate or severe bleeding complications (0.69%) occurred overall. The bleeding rate after subcapsular mass biopsy (3/347; 0.86%) was not statistically different from that noted after nonsubcapsular mass biopsy (5/760; 0.66%) (p = 0.71) or after random biopsy (5/769; 0.65%) (p = 0.71). CONCLUSION: Moderate and severe bleeding complications are rare after subcapsular liver mass biopsy, and their incidence is not significantly higher than that noted after nonsubcapsular mass biopsy or random biopsy. Biopsy of subcapsular lesions should no longer be considered contraindicated.

Abnormalities of the Coronary Arteries in Children: Looking beyond the Origins.

Coronary arterial abnormalities are uncommon findings in children that have profound clinical implications. Although anomalies of the coronary origins are well described, there are many other disease processes that affect the coronary arteries. Immune system-mediated diseases (eg, Kawasaki disease, polyarteritis nodosa, and other vasculiditides) can result in coronary arterial aneurysms, strictures, and abnormal tapering of the vessels. Because findings at imaging are an important component of diagnosis in these diseases, the radiologist's understanding of them is essential. Congenital anomalies may present at varying ages, and findings in hemodynamically significant anomalies, such as fistulas, are key for both diagnosis and preoperative planning. Pediatric heart surgery can result in wide-ranging postoperative imaging appearances of the coronary arteries and also predisposes patients to a multitude of complications affecting the heart and coronary arteries. In addition, although rare, accidental trauma can lead to injury of the coronary arteries, and awareness and detection of these conditions are important for diagnosis in the acute setting. Patients with coronary arterial conditions at presentation may range from being asymptomatic to having findings of myocardial infarction. Recognition of the imaging findings is essential to direct appropriate treatment. ©RSNA, 2017.

The red connection: a review of aortic and arterial fistulae with an emphasis on CT findings.

Fistulae between the aorta and adjacent structures are a rare, emergent, and potentially life-threatening process. Most commonly, aortic fistulae arise secondarily as a complication of prior aortic surgery with fistulization to adjacent structures. Rarely, a primary fistula may arise from the aorta in the setting of a pre-existing aneurysm or from a mass, inflammation, or infection. Although the incidence of aortic fistulae remains low, the frequency continues to increase as aortic surgical interventions and post-surgical follow-up with imaging become more common. Computed tomography (CT) is the modality of choice in evaluating the patient with suspected aortic fistula because of its accessibility and short scan time. In addition, CT allows for more clear depiction of para-aortic or intra-aortic gas than ultrasound or magnetic resonance (MR). This gas may be the first clue of a fistula. Given the high mortality associated with aortic fistulae, familiarity with the imaging findings of the spectrum of aortic fistulae is essential knowledge in the emergency setting. This review will discuss the imaging appearance of aortic and arterial fistulae to the bronchi, esophagus, gastrointestinal tract, ureters, and veins on CT.

Automatization of personal and impersonal discourse with narrative re-telling as a function of age.

When older adults retell an impersonal story, the resulting narratives are typically characterized by more prolixity and less coherence than those produced by younger adults. We aimed to determine whether this pattern is also observed when retelling a personal narrative. Younger and older participants told a personal story three consecutive times. With retelling, no evidence of increased coherence or fluency or reduction in hesitancy was observed for either age group. The nature of autobiographical narrative construction explains why such stories are not subject to automatization. A failure to automatize personal narratives is not, therefore, a symptom of aging.

Discourse compression of elderly adults in a dyadic context.

OBJECTIVES: Elderly adults demonstrate a reduced ability to produce increasingly concise and coherent discourse with repetition when compared with their younger counterparts. We explored whether discourse efficiency and quality would increase with story retelling in a dialogic context. METHOD: Participants were 30 elderly adults aged between 65 and 91 years (M = 77.03, SD = 9.214). Fifteen participants were paired with an elderly adult (EE group) and 15 with a young adult (EY group). Within their dyads, participants constructed a story from a series of cartoon frames. Variables analyzed were narrative duration, word count, fluency, and cohesion. Narratives were repeated 3 times. RESULTS: A compression index was calculated for each variable. For fluency and duration, the compression index for the EY group was significantly higher than for the EE group. While the EY group produced more coherent discourse with repetition, discourse cohesion did not improve with retelling for the EE group. DISCUSSION: A young conversational partner offers a model of consistently compressed and coherent discourse for their older interlocutor. Producing discourse in tandem with a younger adult may thus support older adults' use of social platforms (such as SMS or Facebook) that require a highly compressed message.

Maximising utility does not promote survival.

We argue that maximising utility does not promote survival. Hence, there is no reason to expect people to modulate effort according to a task's opportunity costs. There is also no reason why our evaluation of the marginal opportunity costs of tasks should predictably rise with repetition. Thus, the opportunity cost model cannot explain why tasks typically become harder over time.

When more is less: failure to compress discourse with re-telling in normal ageing.

When young adults tell the same story repeatedly, their narratives become progressively more concise. Although impaired discourse production has been reliably demonstrated in the elderly, changes in narrative production with repetition have not been investigated in this cohort. Thirty young (aged 18-49 years, M=28.77, SD=9.73) and thirty elderly (aged 65+ years, M=73.57, SD=6.80) adults completed a discourse production task involving narrative construction using an eight-frame cartoon. Narratives were repeated 4 consecutive times. Variables analysed were narrative duration, word count and fluency (words/sec). For all variables the compression index for the elderly group was significantly lower than that for young participants. Further, compared to their younger counterparts, elderly adults were less able to improve the cohesion of their narratives with repetition. These findings suggest that the elderly have a reduced capacity to generate and refine discourse representations.

Worry and rumination in older adults: Differentiating the processes.

OBJECTIVES: This study examined the factor structure of the adapted Ruminative Response Scale in a large Australian older adult sample. Previously, the factor structure has only been explored in small UK sample and thus remains tentative. A further objective was to explore overlapping and distinct characteristics of worry, brooding and reflection in relation to coping behaviour which has not previously been examined in older adults. METHOD: A total of 138 older adults aged between 65 and 97 years (M = 77, SD = 7.9) completed a number of instruments to measure worry, rumination, anxiety and coping behaviour. RESULTS: A three-factor structure comprised of worry, brooding and reflection emerged. However, no unique relationship was found between the rumination components (brooding and reflection) and worry and coping pathways. CONCLUSION: The factor structure supports the idea that worry, brooding and reflection are distinguishable constructs in the elderly. However, the lack of differential associations between the rumination components and worry in relation to coping strategies provided evidence that rumination and worry are part of the same theoretical construct of repetitive thought. The implications of these findings for the management of anxiety and depression in the elderly are discussed.

Variations in the relationship between radius of curvature and velocity as a function of joint motion.

A power law describes the relationship between the geometric properties of a trajectory (radius of curvature) and movement kinematics (tangential velocity) in curved drawing movements. Although the power law is a general law of motion, there are conditions under which it degrades. In particular, the power law may be less explanatory of movements around certain joints. The present study considered how varying motion around different joints influenced the fit of the power law. Motions associated with finger and wrist, or elicited by an isometric force production task, were compared. The power law was most explanatory of finger motion and isometric production and least explanatory of wrist motion. The fit of the power law for finger and wrist motion suggested separate laws for each joint system. Since the fit of the power law was better for finger than for wrist motion, there is some suggestion that the power law better explains motion around fewer or simpler joint systems.

Age-related changes in the kinematics of curved drawing movements: relationships between tangential velocity and the radius of curvature.

Age-related motor slowing may result from abnormal trajectory formation. Curved trajectories can be described by a 1/3 power law linking velocity and radius of curvature. As a basic coordinative principle that emerges with maturation, factors producing any variation in this relationship may thus provide insights into age-related changes in the coordination of movement. The authors determined whether variations in the fit of a 1/3 power law with advancing age were associated with temporal or postural constraints. Young and older adults moved under temporal (speed and timing cues) or postural (joint combinations used) constraints, while performing elliptical movements upon a graphics tablet at 1 or 2 Hz. A 1/3 power law was influenced by variations in speed and the joint combinations employed, but reductions of fit were not necessarily linked to force inefficiency. Age-related reductions in the strength of a 1/3 power law were a function of postural constraints.