A cross-sectional study of existential concerns and fear of progression in people with Rheumatoid Arthritis.

OBJECTIVES: People with rheumatoid arthritis (RA) have higher levels of fear of disease progression (FOP) than cancer survivors. In cancer, FOP is inextricably linked with existential concerns. However, this has not been investigated in people with RA. METHODS: We recruited 165 people with RA (96%F) who volunteered for a treatment trial of psychological intervention. Participants completed the Existential Concerns Questionnaire (ECQ) and questionnaires measuring constructs associated with FOP in cancer. We created groups of people with RA, with and without clinically significant levels of FOP (clinical and control groups) and compared their existential concerns. We hypothesized that existential concerns would add to the variance in FOP over and above pain, psychopathology, and disability. RESULTS: Nearly two-thirds of people with RA scored in the clinical range for FOP. The clinical group had higher levels of all existential concerns than the control group. When subscales of the ECQ were entered into a multiple regression with FOP as the dependent variable, death anxiety, meaninglessness and guilt domains accounted for significant variance in FOP. Moreover, when added to a regression equation controlling all other variables, existential concerns continued to account for unique variance in FOP (t = 2.712, p = 0.007). CONCLUSION: Existential concerns were strongly associated with FOP. While this cross-sectional study cannot determine whether existential concerns underlie FOP in RA, these results show robust relationships that warrant future investigation.

The Somatomorphic Matrix-Female: More evidence for the validity of bidimensional figural rating scales for women.

Our study aimed to develop and provide a preliminary psychometric validation of the Somatomorphic Matrix-Female (SM-F), a new bidimensional female figural rating scale which can be used to gauge actual and desired levels of both body fat and muscularity in a consolidated measure, as well as providing an index of actual-desired body discrepancy based on these measures. Across two studies undergraduate women (n Study 1 = 481; n Study 2 = 391) completed the Eating Disorder Examination-Questionnaire, the Body Shape Questionnaire-34, and the Depression Anxiety Stress Scales-21 (Study 1) and the Drive for Thinness Scale and the Drive for Muscularity Scale (Study 2), as well as the SM-F. Overall, the SM-F demonstrated sound content, concurrent, and convergent validity for actual and desired body fat, actual and desired muscularity, and their respective discrepancy scores.

The 'not-so-healthy' appearance pursuit? Disentangling unique associations of female drive for toned muscularity with disordered eating and compulsive exercise.

Today, many women are driven to subscribe to a more athletically oriented appearance ideal hallmarked by muscle tone (referred to as athletic- or fit-looking). However, the constellation of unhealthy eating and exercise behaviors that may accompany the pursuit of toned muscularity among women is not yet well characterized. To address this knowledge gap, our study evaluated the associations among the female drive for toned muscularity and both thinness-oriented disordered eating behaviors (e.g., dietary restriction) and muscularity-oriented disordered eating behaviors (e.g., excessive scrutiny of macro-nutrient values of food), as well as dimensions of compulsive exercise. Participants were 388 Australian undergraduate women who completed an online questionnaire including self-report measures of said constructs. Hierarchical regression models were used to determine whether the drive for toned muscularity accounted for unique variance in eating and exercise behaviors after adjusting for theoretically relevant covariates. Results indicated independent relationships between the drive for toned muscularity and several facets of thinness- and muscularity-oriented disordered eating, as well as compulsive exercise (e.g., exercise rigidity). Our findings further contribute to an emerging literature illustrating that women driven to attain a toned appearance may be vulnerable to engaging in a wide range of maladaptive eating and exercise practices.

Development and Psychometric Properties of the DASS-Youth (DASS-Y): An Extension of the Depression Anxiety Stress Scales (DASS) to Adolescents and Children.

The Depression Anxiety Stress Scales (DASS; Lovibond and Lovibond, 1995b) is a set of psychometrically sound scales that is widely used to assess negative emotional states in adults. In this project, we developed the Depression Anxiety Stress Scales for Youth (DASS-Y) and tested its psychometric properties. Data were collected from 2,121 Australian children and adolescents aged 7-18 (61% female). This sample was split randomly into a calibration group (n = 1075, 61% female) and a cross-validation group (n = 1046, 60% female). First, we used Confirmatory Factor Analysis on the calibration group to test the 3-factor DASS model on 40 items we had developed in previous exploratory studies. We then selected the best-performing 21 items based on both statistical and theoretical considerations, guided by the structure and item content of the adult DASS. We cross-validated this new 21-item model in the second half of the sample. Results indicated good fit for the final 21-item 3-factor DASS model in both groups of children and adolescents. Multiple regression analyses showed that when scores on the other DASS-Y scales were held constant, the DASS-Y Depression scale had a strong negative relationship with positive affect and life satisfaction, the DASS-Y Anxiety scale was strongly associated with physiological hyperarousal, and the DASS-Y Stress scale was associated with excessive worrying. However, the relationship between Stress and worrying was only evident from age 10 onwards. Our results show that the core symptoms that define depression, anxiety and stress in children and adolescents are similar to those previously found in adults. The DASS-Y is a public domain instrument that we hope will prove useful in both research and clinical contexts.

Psychological Well-Being of Australian Actors and Performing Artists: Life Satisfaction and Negative Affect.

BACKGROUND: Anecdotal evidence and media reports suggest that actors and other performing artists experience high levels of depression, anxiety, and stress. However, no empirical study has examined the psychological well-being of this professional group. OBJECTIVE: The Australian Actors' Wellbeing Study (AWS) was conducted to examine the general wellbeing of Australian actors and performing artists. The present paper, reporting on data from the AWS, focuses on two aspects of respondents' psychological well-being: life satisfaction and the experience of negative affect. METHODS: An online survey including several questionnaires was distributed to the Equity Foundation membership representing Australian actors. We report results from the Satisfaction with Life Scale (SWLS) and the Depression Anxiety Stress Scales (DASS) and examine their associations with respondents' sociodemographic and occupational background, including their relationship status and any relationship stress, income from performing, and time taken away from performing. RESULTS: A sample of 782 Australian actors responded to the survey, with 582 participants completing the DASS and 568 the SWLS. Participants reported lower levels of life satisfaction and higher levels of depression, anxiety, and stress than found in the Australian general population. Being in a relationship was associated with better psychological well-being; however, work stress often impacted negatively on relationships. Income had little association with psychological well-being, unless the respondent felt under financial stress. Respondents who took extended periods of time away from performing reported less life satisfaction and more depression than others. CONCLUSION: Australian actors may be at a high risk for poor psychological health. Further research is necessary to establish causality among the variables we examined and to investigate protective factors that may increase well-being in the context of the performing arts industry.

Randomised controlled trial of cognitive behaviour therapy versus mindfulness for people with rheumatoid arthritis with and without a history of recurrent depression: study protocol and design.

INTRODUCTION: Psychosocial treatments have been shown to benefit people with rheumatoid arthritis (RA) on various outcomes. Two evidence-based interventions are cognitive behavioural therapy (CBT) and mindfulness-based stress reduction (MBSR). However, these interventions have been compared only once. Results showed that CBT outperformed MBSR on some outcomes, but MBSR was more effective for people with RA with a history of recurrent depression, with efficacy being moderated by history of depressive episodes. However, this was a post-hoc finding based on a small subsample. We aim to examine whether a history of recurrent depression will moderate the relative efficacy of these treatments when delivered online. METHODS AND ANALYSIS: This study is a randomised controlled trial comparing CBT and MBSR delivered online with a waitlist control condition. History of recurrent depressive episodes will be assessed at baseline. The primary outcome will be pain interference. Secondary outcomes will include pain intensity, RA symptoms, depressive symptoms and anxiety symptoms. Outcome measures will be administered at baseline, post-treatment and at 6 months follow-up. We aim to recruit 300 participants, and an intention-to-treat analysis will be used. Linear mixed models will be used, with baseline levels of treatment outcomes as the covariate, and group and depressive status as fixed factors. The results will demonstrate whether online CBT and MBSR effectively improve outcomes among people with RA. Importantly, this trial will determine whether one intervention is more efficacious, and whether prior history of depression moderates this effect. ETHICS AND DISSEMINATION: The trial has been approved by the Human Research Ethics Committee of the University of Sydney (2021/516). The findings will be subject to publication irrespective of the final results of the study, and based on the outcomes presented in this protocol. TRIAL REGISTRATION NUMBER: Australian New Zealand Clinical Trials Registry (ACTRN12621000997853p).

A randomized controlled trial of a web-based mindfulness programme for people with MS with and without a history of recurrent depression.

BACKGROUND: Evidence shows small positive effects associated with psychological treatments for people with multiple sclerosis (PwMS). In a recent meta-analysis, the treatment with the largest effect size was a mindfulness-based intervention (MBI). OBJECTIVES: We aimed to determine whether an Internet-delivered MBI was beneficial for PwMS. Furthermore, we aimed to investigate history of recurrent depression as a moderator of treatment outcome. METHODS: Participants (N = 132) were assessed based on whether they had a history of recurrent depression, then stratified and randomized to MBI or waitlist. Outcomes were assessed at baseline, post-intervention, and 3 and 6 months. RESULTS: The MBI group reported significantly improved depressive symptoms (primary outcome) compared with the waitlist (p = 0.046, Cohen's d = 0.39). Those with a history of recurrent depression benefitted significantly more than those without (p = 0.034, d = 0.66). There were benefits for health-related quality of life (HRQoL) in the MBI, irrespective of depression history (p = 0.009, d = 0.5). Pain interference was less overall in the MBI group (p < 0.001, d = 0.2), but change over time did not differ from waitlist. There were no treatment effects for anxiety, pain severity or fatigue. CONCLUSION: The Internet-delivered MBI significantly improved depressive symptoms and HRQoL in PwMS. For depression, the benefits were greater for those with a history of recurrent depression. TRIAL REGISTRATION: ACTRN12618001260213, available at: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375598.

A Mindful Parenting Program for Parents Concerned About Child Internalizing Problems: a Randomized Controlled Feasibility Study.

Objectives: This study sought to establish four aspects of feasibility for a mindful parenting program: demand for the program from parents with concerns regarding their child's internalizing problems, acceptability of the program to those parents, preliminary efficacy, and the likelihood of successful expansion of the program to the intended population. Methods: The study was a pilot, randomized controlled trial comparing a mindful parenting program to waitlist. Participants were parents (N = 25) of children aged 3-18 years, with self-reported concerns regarding their child's internalizing problems, recruited from the community. Demand was assessed using recruitment and adherence rates. Acceptability was assessed using parent-reported usefulness. Preliminary efficacy was assessed using parent reports of child internalizing problems, mindful parenting, parenting stress, cognitive emotion regulation, parental experiential avoidance, and parent beliefs about child anxiety. Intervention group parents also provided weekly in-session data on coping in stressful parenting situations. The likelihood of successful expansion was assessed using qualitative feedback on whether and how the program had helped parents manage child internalizing problems, particularly anxiety. Results: Feasibility was established for the four aspects assessed. The program was well-attended and acceptable to parents. Moderate to large effects were found in favor of the intervention group for most parent and child outcomes. Weekly data showed improved coping in difficult parenting situations. Qualitative feedback suggested that parents believed that increased acceptance and empathy had helped them cope with child internalizing problems. Conclusions: Mindful parenting programs may assist parents of children with internalizing problems to manage parenting stress and emotionally regulate themselves, even in difficult parenting moments. They may also reduce child internalizing problems, through improved parental emotion regulation, and greater acceptance of and empathy for their child. Trial Registration: Australian Clinical Trials Registry, registration number ACTRN12620000690954.

Interventions available to adolescents and young adults bereaved by familial cancer: a systematic literature review.

OBJECTIVES: To assess the availability and efficacy of interventions open to adolescents and young adults (AYAs; 15-25 years) bereaved by a parent's or sibling's cancer. METHODS: A systematic review of peer-reviewed literature on interventions available to AYAs bereaved by a parent's or sibling's cancer was conducted through searches of six online databases (PsycINFO, Medline, Scopus, Embase, SWAB and Web of Science Core Collection). RESULTS: Database and reference searches yielded 2985 articles, 40 of which were included in the review. Twenty-two interventions were identified that were available for bereaved young people. However, only three were specific to young people bereaved by familial cancer, and none were specific to AYAs. Interventions primarily provided opportunities for participants to have fun, share their experiences and/or memorialise the deceased; psychoeducation about bereavement, grief and coping was less common. Only six interventions had been satisfactorily evaluated, and no intervention targeted or analysed data for AYAs separately. Overall, some evidence suggested that interventions (especially those that were theoretically grounded) had positive effects for bereaved young people. However, benefits were inconsistently evidenced in participants' self-reports and often only applied to subgroups of participants (eg, older youths and those with better psychological well-being at baseline). CONCLUSIONS: Considering the very limited number of interventions specific to bereavement by familial cancer and the lack of interventions targeting AYAs specifically, it is unclear whether currently available interventions would benefit this population. The population of AYAs bereaved by familial cancer is clearly under-serviced; further development and evaluation of interventions is needed.

Factor structure and psychometric properties of the Muscularity-Oriented Eating Test in university women in Australia.

OBJECTIVE: Toned muscularity continues to emerge as a salient aspect of women's body image. However, there is a dearth of research investigating the potentially maladaptive eating practices and related cognitions that accompany the drive for muscularity in women. This may be attributable to the limited empirical and clinical attention previously given to muscularity-oriented disordered eating and, accordingly, the lack of validated measures assessing these concerns. To address this knowledge gap, our study aimed to provide a preliminary evaluation of the factor structure and core psychometric properties of a recently developed measure of muscularity-oriented disordered eating, the Muscularity-Oriented Eating Test (MOET), in university women in Australia. METHOD: Participants included 419 university women who completed the 15-item MOET and other self-report measures for validity evaluation as part of an online survey. Data from split-half samples were used to undertake an exploratory factor analysis and subsequent confirmatory factor analysis. RESULTS: Factor analytic results supported a briefer (12-item), one-factor scale in this sample of university women. The internal consistency reliability and validity (convergent and discriminant) of this 12-item unidimensional MOET was supported. DISCUSSION: Our study provides preliminary support for this modified MOET as a psychometrically sound self-report measure of muscularity-oriented disordered eating in university women in Australia, providing a useful tool for understanding maladaptive eating behaviors and cognitions concomitant to the pursuit of muscularity in this population.

Development of a Web-Based Mindfulness Program for People With Multiple Sclerosis: Qualitative Co-Design Study.

BACKGROUND: Mindfulness-based stress reduction is an efficacious treatment for people with chronic health problems; however, it is highly intensive and time-consuming, which is a barrier for service provision. OBJECTIVE: This study aims to develop an internet-delivered adapted version of mindfulness-based stress reduction for people with multiple sclerosis to make the intervention more accessible. METHODS: We co-designed a web-based mindfulness program with end users, that is, people with multiple sclerosis (N=19). Iterative feedback was also collected from a subsample of the initial group of end users (n=11), and the program was reviewed by experts (n=8). RESULTS: We identified three main themes common to people with multiple sclerosis: dealing with uncertainty and fears for the future, grief and loss, and social isolation. These themes were incorporated into narratives throughout the program. People with multiple sclerosis who reviewed the program gave feedback that the program was relatable, feasible, and acceptable. Experts agreed that the program appropriately represented the main tenets of mindfulness. Iterative feedback was used to further refine the program. CONCLUSIONS: The web-based mindfulness program that we developed was viewed positively by both experts and end users. The program reflects common concerns for people with multiple sclerosis and has the potential to meet important unmet psychological needs. A randomized controlled trial was planned to determine the efficacy of the program.

Who's the 'bigger' man? Parsing the relationships between masculinity and men's muscularity dissatisfaction.

Muscularity dissatisfaction is documented to be a pervasive phenomenon among men. While previous studies have examined theoretically relevant predictors of muscularity dissatisfaction, such as adherence to traditional masculine norms, to the best of our knowledge we are not aware of empirical research that has assessed how perceived discrepancies in one's level of masculinity may also be associated with these concerns. Therefore, the objective of this study was to determine whether perceived deficits in masculinity bear predictive utility over and above adherence to traditional masculine norms in the context of muscularity dissatisfaction. An online survey that included measures assessing the aforementioned constructs was completed by 390 university and community adult men. A hierarchical regression analysis showed that while adherence to masculine norms was associated with increased muscularity dissatisfaction, masculine role discrepancy (and attendant stress) were particularly strong predictors of muscularity dissatisfaction. Our findings make a novel contribution to the male body image literature by demonstrating the relative importance of perceived discrepancies in masculinity, and related stress, in the context of muscularity dissatisfaction. Pending replication in relevant clinical samples using prospective designs, this study provides preliminary evidence that masculine role discrepancies may be promising targets to help allay muscularity concerns among men.

'Big boys don't cry': Examining the indirect pathway of masculinity discrepancy stress and muscle dysmorphia symptomatology through dimensions of emotion dysregulation.

Prevailing conceptualizations of muscle dysmorphia (MD) have highlighted the role of adherence to stereotypical ideals of masculinity. In addition, the endorsement of masculine norms has been associated with dysfunctional emotional regulation, itself a correlate of body image psychopathology. Building on this, the present study sought to investigate the indirect relationship between masculinity discrepancy stress (i.e., distress related to one's perceived discrepancy in masculinity) and MD symptomatology via different facets of emotion dysregulation among adult men. A sample of 391 university and community men aged 18-50 years completed an online survey measuring the aforementioned constructs. A test of parallel indirect pathways revealed that emotion dysregulation, as a unitary construct, accounted for a substantial proportion (29.3 %) of the total association between masculinity discrepancy stress and MD symptomatology. Further, a significant unique indirect pathway was found through the specific emotion dysregulation facet of lack of access to adaptive emotion regulation strategies. Together, these findings suggest that emotion dysregulation is a particularly important construct to consider in understanding the relationship between perceived discrepancies in masculinity and MD symptomatology.

Alcohol Use by Australian Actors and Performing Artists: A Preliminary Examination from the Australian Actors' Wellbeing Study.

BACKGROUND: Anecdotal and media reports suggest that actors and performing artists are vulnerable to high levels of alcohol use. However, little empirical research is available to document the extent and correlates of alcohol use amongst these artists, particularly in an Australian context. OBJECTIVE: This study investigated alcohol use in a sample of Australian actors and other performing artists and its associations with sociodemographic background, psychological wellbeing, and work stress. METHODS: An online survey was distributed to the Equity Foundation membership representing Australian actors and performing artists. The survey included questions on sociodemographic and occupational background and psychological wellbeing (DASS-21), as well as the AUDIT questionnaire to assess self-reported alcohol consumption. A sample of 620 performing artists responded to the survey, a large majority of whom were actors. RESULTS: Australian actors and performing artists appear to consume alcohol at levels that are higher than those found in the general Australian population. About 40% of men and 31% of women were classified as drinking alcohol at potentially harmful or hazardous levels. Alcohol use was not strongly associated with age, education, or income, but it had a relationship with poorer psychological wellbeing. About 50% of respondents reported that their alcohol drinking was related to work stress as a performer. This perception was more pronounced amongst those performers who reported drinking at harmful levels. CONCLUSIONS: Australian actors and performing artists appear to be an at-risk population for harmful or hazardous alcohol use.

An investigation of distress tolerance and difficulties in emotion regulation in the drive for muscularity among women.

Despite the negative emotional experiences that often accompany the pursuit of an idealized appearance, we know little about emotion regulation in the context of female drive for muscularity. To address this knowledge gap, we examined whether distress tolerance and difficulties in emotion regulation were significantly associated with the drive for toned muscularity among women. In this study, 221 Australian university women completed an online survey assessing drive for muscularity, distress tolerance, and emotion regulation difficulties. Results revealed that low distress tolerance and emotion regulation difficulties were positively associated with drive for muscularity attitudes and behaviors, after controlling for body mass index and general negative affect. Our findings suggest that women with a range of distress tolerance and emotion regulation difficulties, particularly the urgent need to regulate, and non-acceptance of, distress may experience a higher drive for muscularity. This study provides preliminary evidence that specific aspects of distress tolerance and poor emotion regulation may be promising targets in prevention and treatment interventions aimed to address the excessive drive for muscularity among women.

[Empirical study of learning success among first-year students in health education]. / A tanulás sikerességének vizsgálata egészségügyi tanulmányokat folytató elsoéves hallgatók körében.

Introduction: Comprehensive predictors of first-year students' academic performance, including pre-university experience, can be found at both individual and infrastructural levels that can be measured and used to increase academic performance and contribute to student mental health. Aim: To study the characteristics of students who are beginning their studies in medical, dental, pharmacy and health care organization. Method: Analysis of a database obtained through questionnaire data among first-year Semmelweis University students (n = 550). Significant explanatory variables influencing student performance were determined by logistic regression. Results: Different faculties and prestige channels have different success factors and student needs, the fulfillment of which also serves the maintenance of student mental health. Two groups were defined: (i) factors independent of age (perseverance value, religious belief, WHO value of well-being, importance of sport, trust), (ii) faculty-specific factors (Faculties of Medicine and Dentistry: parental influence on learning; Faculty of Pharmaceutical Sciences: the importance of relationships is high; Faculty of Health Sciences: parental qualifications are decisive). Conclusion: At the start of a student's life, measurements can uncover factors that, if learned, can facilitate later successful studies, preventing early school leaving. During the course of studies, these features can be monitored continuously, so that the necessary interventions can be made to ensure student success. Orv Hetil. 2020; 161(4): 139-150.

The Interpersonal Mindfulness in Parenting Scale in Mothers of Children and Infants: Factor Structure and Associations With Child Internalizing Problems.

Objectives: Mindful parenting, measured by the Interpersonal Mindfulness in Parenting scale (IMP), is beneficial for parents and children. However, the IMP has not been validated in English-speaking parents. Further, little is known about whether mindful parenting is similar in parents of children vs. infants, or how it reduces child internalizing problems. We sought to validate the IMP in English-speaking mothers of children and infants, and to examine relationships between the facets of mindful parenting, child internalizing problems and parent variables related to internalizing. Methods: Using confirmatory factor analyses, we examined the fit of various models of mindful parenting in English-speaking community-recruited mothers of children aged 3-18 years (n = 396) and infants aged 0-2 years (n = 320). We used regression analyses to investigate relationships between the facets of mindful parenting, child internalizing problems, and parent variables including parental experiential avoidance, unhelpful beliefs about child anxiety and accommodation of child anxiety. Results: Mindful parenting can be measured in English-speaking mothers, using either a 5- or 6-factor, 29-item version of the IMP. These versions of the IMP operate similarly for mothers of children and infants. Child internalizing problems and related parent variables were best predicted by non-judgmental acceptance of parenting in mothers of children, and emotional self-awareness and non-reactivity in mothers of infants. Conclusions: The IMP is a valid measure of mindful parenting in English-speaking mothers of children and infants. Mindful parenting predicts child internalizing problems and related parent variables, suggesting that mindful parenting programs could benefit families of children with internalizing problems, potentially by reducing parental experiential avoidance, unhelpful beliefs about or accommodation of child anxiety.

Eating Disorder Symptoms in Australian Actors and Performing Artists.

AIMS: Anecdotal evidence suggests that actors and other performing artists are under great pressure to conform to idealized appearances and body types. The pursuit of such appearances may trigger eating disorder symptoms, such as unhealthy attitudes towards body weight and shape. Thus far, there has been no dedicated empirical study of the prevalence of such problems in Australian actors and performing artists specifically. Therefore, this study sought to examine eating disorder symptomatology in Australian actors and performing artists. METHODS: An online survey was distributed to the Equity Foundation membership representing Australian actors and performing artists, of whom 573 individuals completed the survey. This survey gauged demographic information and eating disorder symptoms using the psychometrically validated Eating Disorder Diagnostic Scale (EDDS). RESULTS: A large proportion of actors reported unhealthy attitudes such as 'feeling fat' even though they are of normal weight or underweight; reported an extreme fear of gaining weight; and evaluated their self-worth based on their body weight and shape, particularly women. Results also showed that 2.5% of women in the study met the diagnostic criteria for anorexia nervosa and 13% met diagnostic criteria for bulimia nervosa based on their scores on the EDDS. DISCUSSION: Performers may be a particularly at-risk population for the development and/or maintenance for a range of eating disorders.

Negative psychological correlates of the pursuit of muscularity among women.

OBJECTIVE: There is increasing public and scientific focus on women's pursuit of a muscular and toned appearance. However, the psychological correlates of women's drive for muscularity are currently unclear. Therefore, we examined the associations of drive for muscularity with four important negative psychological indices among women: eating disorder (ED) symptoms, and symptoms of depression, anxiety, and stress. METHOD: A sample of 221 university women completed an online survey that included measures assessing the aforementioned constructs. RESULTS: Drive for muscularity evidenced positive associations with all negative psychological indices, except for anxiety. Muscularity-oriented attitudes, as opposed to behaviors, demonstrated the strongest associations with ED and depression symptoms. DISCUSSION: Our findings make a novel contribution to the scant literature by demonstrating that women who endorse attitudes and/or behaviors geared toward attaining the female muscular ideal may be susceptible to experiencing ED symptoms and negative emotional states. This study provides preliminary evidence that muscularity-oriented attitudes, in particular, may be a promising target for the treatment of EDs and negative emotional states in women with a preoccupation toward muscularity.

The Effect of Mindfulness Interventions for Parents on Parenting Stress and Youth Psychological Outcomes: A Systematic Review and Meta-Analysis.

Background: The psychological well-being of parents and children is compromised in families characterized by greater parenting stress. As parental mindfulness is associated with lower parenting stress, a growing number of studies have investigated whether mindfulness interventions can improve outcomes for families. This systematic review and meta-analysis evaluates the effectiveness of mindfulness interventions for parents, in reducing parenting stress and improving youth psychological outcomes. Methods: A literature search for peer-reviewed articles and dissertations was conducted in accordance with PRISMA guidelines in the PsycInfo, Medline, PubMed, CINAHL, Web of Science, Cochrane Central Register of Controlled Trials, and ProQuest Dissertations & Theses databases. Studies were included if they reported on a mindfulness-based intervention delivered in person to parents with the primary aim of reducing parenting stress or improving youth psychological outcomes. Results: Twenty-five independent studies were included in the review. Eighteen studies used a single group design and six were randomized controlled trials. Within-groups, meta-analysis indicated a small, post-intervention reduction in parenting stress (g = 0.34), growing to a moderate reduction at 2 month follow-up (g = 0.53). Overall, there was a small improvement in youth outcomes (g = 0.27). Neither youth age or clinical status, nor time in mindfulness training, moderated parenting stress or overall youth outcome effects. Youth outcomes were not moderated by intervention group attendees. Change in parenting stress predicted change in youth externalizing and cognitive effects, but not internalizing effects. In controlled studies, parenting stress reduced more in mindfulness groups than control groups (g = 0.44). Overall, risk of bias was assessed as serious. Conclusions: Mindfulness interventions for parents may reduce parenting stress and improve youth psychological functioning. While improvements in youth externalizing and cognitive outcomes may be explained by reductions in parenting stress, it appears that other parenting factors may contribute to improvements in youth internalizing outcomes. Methodological weaknesses in the reviewed literature prevent firm conclusions from being drawn regarding effectiveness. Future research should address these methodological issues before mindfulness interventions for parents are recommended as an effective treatment option for parents or their children.