Effect of Previous Adverse Reproductive Health Outcomes on Young Women's Engagement in a Health Coaching Intervention to Improve Contraceptive Continuation.

STUDY OBJECTIVE: Nonadherence in sexual risk reduction interventions might be common among adolescents. We compared intervention completion rates among adolescent and young adult women with and without a previous pregnancy or sexually transmitted infection (STI) participating in a program to improve contraceptive continuation. DESIGN: Secondary data analysis from a feasibility study of a health-coaching intervention to improve contraceptive continuation. SETTING: Three urban pediatric clinics in Philadelphia. PARTICIPANTS: Women ages 14-22 years who were English-speaking, sexually active in the past year, not desiring pregnancy in the next year, and starting a new contraceptive method. INTERVENTIONS: At baseline, participants completed a sociodemographic questionnaire and semistructured interview, followed by 5 monthly coaching sessions. Interviews and coaching sessions were audio-recorded, transcribed, and coded for thematic content. MAIN OUTCOME MEASURES: Intervention completion was defined as the number of completed coaching sessions. Secondary outcomes were qualitatively explored group differences in reproductive knowledge, attitudes, and risk perception. RESULTS: Participants with a previous adverse outcome (a previous STI and/or a previous pregnancy) completed fewer coaching sessions than those without such history (median: 2 vs 4; P = .03). Both groups had low HIV/STI knowledge, negative attitudes toward pregnancy, and low HIV/STI risk perception. Those with a previous adverse reproductive outcome held more negative attitudes toward condoms. CONCLUSION: Despite similar reproductive knowledge, attitudes, and risk perception, young women who have experienced an adverse reproductive outcome might be less likely to fully engage in sexual risk reduction interventions. Future studies should confirm these findings and consider strategies to optimize the intervention's reach for vulnerable youth.

Objectified Body Consciousness (OBC) in Eating Psychopathology.

Objectified body consciousness (OBC) appears to play a crucial role in eating and body-related disturbances, which typically emerge during adolescence. The 24-item OBC Scale (OBCS) has been employed in eating disorder (ED) research and school-based adolescent samples, but evidence for its psychometric proprieties exists only in adult (nonclinical) populations. We evaluated (a) the construct validity and reliability of the 24-item OBCS with data collected from 1,259 adolescent girls and boys from the community (Study 1) and 643 adolescents of both genders with an ED (Study 2) and (b) whether the instrument functions similarly and equivalently measures the underlying construct(s) across gender and samples (i.e., test of measurement equivalence/invariance; Study 3). Results upheld the three-factor structure and measurement equivalence/invariance of the 24-item OBCS across gender and samples. OBCS subscale scores were internally consistent and stable over a 4-week period. OBCS subscales discriminated community participants with high and low ED symptom levels with fair accuracy, as well as community participants from those with an ED. They were also associated with five constructs closely related to both OBC and ED psychopathology. Latent mean comparisons across samples and gender were performed and discussed. Implications and directions for future research are also outlined.

Prospective Psychosocial Predictors of Onset and Cessation of Eating Pathology amongst College Women.

The course of college women's eating pathology is variable. Little is known about psychosocial factors prospectively predicting maintenance/cessation or the new onset of clinically significant disordered eating symptoms. This study aimed to address these research gaps. College women (N = 2202) completed an assessment of eating pathology and potential risk/maintenance factors at two time points, 9 months apart. Logistic regression models indicated that elevated body dissatisfaction, thin-ideal internalization, self-objectification, negative affectivity and lower self-esteem at baseline predicted 'onset' of clinically significant disordered eating symptomatology at follow-up. Greater self-esteem and lower initial levels on the remaining risk factors predicted subsequent 'cessation' of clinically significant disordered eating symptoms. Self-objectification had greater explanatory value with regard to 'cessation' and 'onset' relative to the remaining traditionally accepted factors that demonstrated half as much predictive power or less. Practical implications are discussed.

Mechanisms of influence of body checking on binge eating / Mecanismos de influencia de las conductas de comprobación del cuerpo en los atracones

Despite the theorized role of body checking behaviours in the maintenance process of binge eating, the mechanisms by which they may impact binge eating remain unclear. Using objectification model of eating pathology as a theoretical framework, the authors examined the potential intervening roles of body shame, appearance anxiety, and dietary restraint in the pathway between body checking and binge eating. Data collected from a large sample of treatment-seeking people with Bulimic-type Eating Disorders (N = 801) were analysed trough structural equation modelling. Results showed that, regardless of specific DSM-5 diagnostic categories, body checking behaviours were indirectly associated with binge eating and dietary restraint through body shame and appearance anxiety, whereas dietary restraint was directly linked to binge eating. The findings have clinical utility as they contribute to gaining insight into how critical scrutiny of one's body may act in several indirect ways to affect binge eating. We discuss practical implications of the findings (AU)

A pesar del papel teórico que desempeñan las conductas de comprobación corporal en el proceso de mantenimiento de la conducta de atracón, los mecanismos por los que pueden afectar a los atracones siguen sin estar claros. Tomando el modelo de la objetivación de la patología alimentaria como marco teórico, los autores examinaron las posibles funciones que desempeñan la vergüenza corporal, la ansiedad por la apariencia y la restricción alimentaria en la comprobación del cuerpo y los atracones. Los datos recogidos en una amplia muestra de pacientes con trastorno de tipo bulímico en busca de tratamiento (N = 801) se analizaron a través de modelos de ecuaciones estructurales. Los resultados mostraron que, independientemente de las categorías diagnósticas específicas del DSM-5, las conductas de comprobación estaban asociadas indirectamente con los atracones y la restricción alimentaria a través de la vergüenza corporal y la ansiedad por la apariencia, mientras que la restricción alimentaria estaba directamente asociada con los atracones. Los resultados aportan utilidad clínica dado que contribuyen a la idea de cómo el examen crítico del propio cuerpo puede afectar de forma indirecta a las conductas de atracón. Se discuten las implicaciones prácticas de los hallazgos (AU)

Mechanisms of influence of body checking on binge eating.

Despite the theorized role of body checking behaviours in the maintenance process of binge eating, the mechanisms by which they may impact binge eating remain unclear. Using objectification model of eating pathology as a theoretical framework, the authors examined the potential intervening roles of body shame, appearance anxiety, and dietary restraint in the pathway between body checking and binge eating. Data collected from a large sample of treatment-seeking people with Bulimic-type Eating Disorders (N = 801) were analysed trough structural equation modelling. Results showed that, regardless of specific DSM-5 diagnostic categories, body checking behaviours were indirectly associated with binge eating and dietary restraint through body shame and appearance anxiety, whereas dietary restraint was directly linked to binge eating. The findings have clinical utility as they contribute to gaining insight into how critical scrutiny of one's body may act in several indirect ways to affect binge eating. We discuss practical implications of the findings.

A pesar del papel teórico que desempeñan las conductas de comprobación corporal en el proceso de mantenimiento de la conducta de atracón, los mecanismos por los que pueden afectar a los atracones siguen sin estar claros. Tomando el modelo de la objetivación de la patología alimentaria como marco teórico, los autores examinaron las posibles funciones que desempeñan la vergüenza corporal, la ansiedad por la apariencia y la restricción alimentaria en la comprobación del cuerpo y los atracones. Los datos recogidos en una amplia muestra de pacientes con trastorno de tipo bulímico en busca de tratamiento (N = 801) se analizaron a través de modelos de ecuaciones estructurales. Los resultados mostraron que, independientemente de las categorías diagnósticas específicas del DSM-5, las conductas de comprobación estaban asociadas indirectamente con los atracones y la restricción alimentaria a través de la vergüenza corporal y la ansiedad por la apariencia, mientras que la restricción alimentaria estaba directamente asociada con los atracones. Los resultados aportan utilidad clínica dado que contribuyen a la idea de cómo el examen crítico del propio cuerpo puede afectar de forma indirecta a las conductas de atracón. Se discuten las implicaciones prácticas de los hallazgos.

Are the Male Body Dissatisfaction and Drive for Muscularity Scales reliable and valid instruments?

The Drive for Muscularity Scale and Male Body Dissatisfaction Scale were developed for use with men and correspond to measures of drive for thinness and body dissatisfaction in women. The psychometric properties of these measures were evaluated in a sample of 655 Italian men, who completed other 11 measures also. Both scales demonstrated excellent internal consistency and temporal stability as well as criterion-related and concurrent validity. Both measures distinguished between men with high and low levels of disordered eating. Confirmatory factor analysis replicated the unidimensional factor structure of both scales. Directions for future research are discussed.