Measurement invariance and psychometric properties of three positive body image measures among cisgender sexual minority and heterosexual women.

Positive body image is a multidimensional construct consisting of various facets including body appreciation, body image flexibility, and functionality appreciation measured via the Body Appreciation Scale-2 (BAS-2), Body Image-Acceptance and Action Questionnaire-5 (BI-AAQ-5), and Functionality Appreciation Scale (FAS), respectively. Research has supported the unidimensional factor structure of these measures; however, invariance testing based on sexual identity has yet to be conducted. The study's primary aim was to assess the measurement invariance of the BAS-2, BI-AAQ-5, and FAS between sexual minority and heterosexual women. The secondary aim was to assess the psychometric properties of each positive body image measure among each sample. Participants were predominantly White, cisgender women who identified as a sexual minority (n = 310) or heterosexual (n = 360) and completed online questionnaires of positive body image, eating behaviors, and mental and physical health. Results supported invariance with no differences in BAS-2 or BI-AAQ-5 scores. A significant difference with a small effect size was found in FAS scores, with sexual minority women reporting lower FAS scores. Findings supported the BI-AAQ-5 and FAS's incremental validity on perceived mental health. Overall, results suggest that the BAS-2, BI-AAQ-5, and FAS scores can be compared among women of varying sexual identities.

Weight bias reduction among first-year medical students: A quasi-randomized, controlled trial.

Implicit and explicit weight bias is prevalent among healthcare professionals and results in negative outcomes, including weak physician-patient rapport, low patient trust in physicians, and avoidance of healthcare. This study aimed to decrease weight bias in medical students via a one-session, curriculum-based intervention founded on the elaboration likelihood model (ELM). First-year medical students (N = 101) were quasi-randomly assigned to a group-based experimental or education-based control intervention. Data collected included measures of implicit and explicit weight bias and empathy (pre-intervention and up to 2 days post-intervention), and thoughts regarding weight bias (collected at the end of the intervention). Social desirability was identified as an important covariate. After controlling for social desirability, the intervention group showed no greater reduction in multi-item explicit bias rating scales or a computerized implicit bias task than the control group. Both groups showed less discomfort when near individuals with obesity (p < 0.01). The intervention group wrote a greater number of statements about weight bias and obesity (p < 0.05) and a greater number of statements about the harms of weight bias (p < 0.001) than the control group on a thought-listing task. Results highlight use of the ELM and the importance of controlling for social desirability in weight bias interventions. A thought-listing task captured unique intervention effects, highlighting potential gaps in the assessment of weight bias.

Factor structure and psychometric properties of the clinical impairment assessment 3.0 (CIA) in a clinical eating disorder sample.

PURPOSE: The aim of this study was to investigate the psychometric properties and the factor structure of the Clinical Impairment Assessment 3.0 (CIA) utilizing a confirmatory factor analysis in a large clinical sample of ED patients. METHODS: A total of 260 patients between the ages of 18 and 45 who completed assessments in a partial hospitalization or residential treatment program at an ED treatment facility between December 2012 and December 2016 were included in the analyses. Assessment measures included the CIA, EDE-Q, BDI-II, WHODAS, and a demographic questionnaire. RESULTS: Results favored a bifactor model with a strong general factor and three unreliable subfactors. The CIA showed strong construct validity with other measures of ED pathology (EDE-Q) and health-related QoL (WHODAS). Furthermore, admission CIA scores were predictive of treatment outcomes. CONCLUSIONS: The CIA assesses general psychosocial impairment, supporting the use of a total, but not subscale scores, among symptomatic ED samples in the United States.

Construct validity of the Levels of Emotional Awareness Scale among women high in eating disorder symptoms: a cross-sectional study.

PURPOSE: The Levels of Emotional Awareness Scale (LEAS), a measure of the ability to identify and describe one's own and others' emotions, may complement work with women with disordered eating symptoms. The study purpose was to (a) examine differences in hand (LEAS) versus computerized (e-LEAS) scoring methods and (b) examine the e-LEAS' psychometric properties, including convergent and discriminant validity, among women endorsing eating disorder symptoms. METHODS: Forty women (ages 18-21) scoring high on a self-report measure of disordered eating symptoms completed the LEAS and measures of convergent validity including a self-report measure of alexithymia (the perceived ability to identify and describe one's own emotions) and a measure of facial affect recognition as well as discriminant validity, including affect and facial memory. Inter-rater reliability was assessed via a two-way mixed effects model and correlations between the LEAS and the study constructs were examined. RESULTS: Computerized scoring (e-LEAS) offered benefits over hand scoring and correlations between LEAS and e-LEAS were statistically significant. Better total emotional awareness scores on the e-LEAS were significantly associated with more perceived difficulty identifying and describing emotions. Better total emotional awareness scores were also significantly associated with better facial memory and greater depression scores. The e-LEAS showed weak associations with facial affect recognition. CONCLUSION: The e-LEAS offers practical advantages over the LEAS in the assessment of emotional awareness among women endorsing eating disorder symptoms. Results suggest that the e-LEAS measures the ability to describe emotional experiences in oneself and others, but not facial affect recognition. LEVEL OF EVIDENCE: Level V: Evidence obtained from a cross-sectional descriptive study.

Neuropsychological predictors of health and safety abilities in dementia.

The Independent Living Scales Health and Safety (ILS HS) scale is commonly used by neuropsychologists when evaluating older adults' instrumental activities of daily living (IADLs). However, there is a minimal amount of research on its use in dementia populations and, specifically, its relationship to other neuropsychological measures. The present study investigated relationships between the ILS HS scale and measures of cognition and depression. The study utilized archival data from a sample (N = 142) of older adults (mean age = 77.85) diagnosed with dementia, who were evaluated at Saint Louis University Medical Center and administered the ILS HS scale as part of a larger clinical neuropsychological evaluation. Multiple regression analyses demonstrated that up to 37% of the variance in ILS HS performance was accounted for by demographic variables, premorbid intelligence, and cognitive functioning (e.g., global cognition, delayed verbal recall, and executive functioning), and regression models demonstrated medium to large effect sizes. Depression and self- or informant-reported IADLs were unrelated to the ILS HS scale. Results suggest that older adults' ability to function in health and safety-related situations requires a range of cognitive abilities. Performance on these measures may help guide clinical decision making regarding independent living and treatment planning.

Differences in alexithymia, emotional awareness, and facial emotion recognition under conditions of self-focused attention among women with high and low eating disorder symptoms: a 2 x 2 experimental study.

BACKGROUND: Women with eating disorders generally perform more poorly on measures of alexithymia, defined as difficulty identifying and describing emotions, and theory of mind, or the ability to infer what others are thinking and feeling. The extent to which these abilities may be influenced by variables such as self-focused attention, or directing attention toward internally generated information, has yet to be investigated. Thus, the purpose of the present study was to examine differences between women high and low in disordered eating symptoms on measures of emotional awareness and facial affect recognition under conditions of high and low self-focused attention. METHODS: University women scoring high or low on a measure of disordered eating (n = 79) were randomly assigned to a condition of high or low self-focused attention. Outcomes included alexithymia (self-rated ability to identify and describe emotions), emotional awareness (ability to describe the emotions of oneself and others), and facial affect recognition. Scores on a measure of negative affect were statistically controlled. RESULTS: Women with high disordered eating symptom scores rated themselves as having more difficulties identifying, but not describing emotions after controlling for negative affect, but demonstrated greater difficulties describing their own and others' emotions on a measure of emotional awareness. In the self-focused attention condition, women scored lower on self emotional awareness and were quicker to identify expressions of negative facial affect regardless of eating disorder symptom status than women in the non-self-focused attention condition. There were no significant interactions between eating disorder status and self-focused attention. CONCLUSIONS: Further examination of different types of emotion recognition and description in oneself and others as well as processes that may influence these abilities is warranted.

Validation of the Body Appreciation Scale-2 and relationships to eating behaviors and health among sexual minorities.

Although the study of positive body image continues to expand, researchers have predominantly focused the study of this newer construct among presumed heterosexual participants. The purpose of the present study was to examine the factor structure of a measure of positive body image, the Body Appreciation Scale-2 (BAS-2), among sexual minority participants. The present study also sought to psychometrically validate the BAS-2 among sexual minorities by assessing its relationship with other facets of positive body image, including functionality appreciation and body image flexibility, as well as other related constructs, such as body dissatisfaction, disordered eating behaviors, intuitive eating behaviors, and physical and mental health. Results from a confirmatory factor analysis of 223 sexual minority adults (Mage = 32.45, SD = 10.07) indicated that the BAS-2 displayed strong factorial validity with a unitary factor structure. Furthermore, the BAS-2's construct validity was supported based on correlations with other measures of positive body image, body dissatisfaction, and disordered eating behavior. Results from this cross-sectional study supported a relationship between body appreciation and intuitive eating behaviors, as well as physical and mental health among sexual minority participants. These findings provide an initial understanding of body appreciation and other related constructs among sexual minority individuals.

A factor analytic investigation of the Mercy Evaluation of Multiple Sclerosis.

OBJECTIVE: Neurocognitive deficits commonly are an accompanying feature of Multiple Sclerosis (MS). A brief, yet comprehensive neuropsychological battery is desirable for assessing the extent of these deficits. Therefore, the present study examined the validity of the Mercy Evaluation of Multiple Sclerosis (MEMS) for use with the MS population. METHODS: Archival data from individuals diagnosed with MS (N = 378) by independent neurologists was examined. Cognitive domains assessed included processing speed and attention, learning, and memory, visuospatial, language, and executive functioning. A mean battery index was calculated to provide a general indicator of cognitive impairment within the current sample. RESULTS: Overall performance across participants was found to be in the lower limits of the average range. Results of factor analytic statistical procedures yielded a four-factor solution, accounting for 67% of total variance within the MEMS. Four neurocognitive measures exhibited the highest sensitivity in detecting cognitive impairment, constituting a psychometrically established brief cognitive screening battery, which accounted for 83% of total variance within the mean battery index score. CONCLUSION: Overall, the results of the current study suggest appropriate construct validity of the MEMS for use with individuals with MS, as well as provide support for previously established cognitive batteries.

The Professionalism and Integrity in Research Program: Description and Preliminary Outcomes.

Violations of rules and regulations in research can cause significant problems for human participants, animal subjects, data integrity, institutions, and investigators. The Professionalism and Integrity in Research Program (PI Program) provides remediation training that addresses the root causes of violations of rules and regulations in research. Through assessments, a three-day workshop, and follow-up coaching calls, the PI Program teaches evidence-based decision-making strategies designed to help researchers to compensate for bias, uncertainty, and work-related stress, and foster the skills needed to oversee research projects in today's complex regulatory environments. Across its first three years (2013-2015), the program trained 39 researchers from 24 different institutions in the United States. Participant evaluations of the program's faculty and workshop content were highly positive (4.7-4.8 and 4.5-4.6, respectively, on a 5-point scale). Preliminary program outcome assessment using validated measures of professional decision making and cognitive distortions in a pre- and postworkshop design indicated significant improvements. A follow-up survey of participants found statistically significant increases in a variety of target behaviors, including training research staff members to foster compliance and research quality, using standard operating procedures to support compliance and research integrity, performing self-audits of research operations, reducing job stressors, actively overseeing the work of the research team, and seeking help when experiencing uncertainty. Assessment of the PI Program was conducted with modest sample sizes, yet evaluation, outcome assessment, and self-reported survey data provided statistically significant evidence of effectiveness in achieving program goals.

Replication and extension of the dual pathway model of disordered eating: The role of fear of negative evaluation, suggestibility, rumination, and self-compassion.

OBJECTIVE: The dual pathway model, a theoretical model of eating disorder development, suggests that thin ideal internalization leads to body dissatisfaction which leads to disordered eating via the dual pathways of negative affect and dietary restraint. While the dual pathway model has been a valuable guide for eating disorder prevention, greater knowledge of characteristics that predict thin ideal internalization is needed. METHOD: The present study replicated and extended the dual pathway model by considering the addition of fear of negative evaluation, suggestibility, rumination, and self-compassion in a sample of community women and female university students. RESULTS: Results showed that fear of negative evaluation and suggestibility predicted thin ideal internalization whereas rumination and self-compassion (inversely) predicted body dissatisfaction. Negative affect was predicted by fear of negative evaluation, rumination, and self-compassion (inversely). DISCUSSION: The extended model fit the data well in both samples. Analogue and longitudinal study of these constructs is warranted in future research.

Making Professional Decisions in Research: Measurement and Key Predictors.

The professional decision-making in research (PDR) measure was administered to 400 National Institutes of Health (NIH)-funded and industry-funded investigators, along with measures of cynicism, moral disengagement, compliance disengagement, impulsivity, work stressors, knowledge of responsible conduct of research (RCR), and socially desirable response tendencies. Negative associations were found for the PDR and measures of cynicism, moral disengagement, and compliance disengagement, while positive associations were found for the PDR and RCR knowledge and positive urgency, an impulsivity subscale. PDR scores were not related to socially desirable responding, or to measures of work stressors and the remaining impulsivity subscales. In a multivariate logistic regression analysis, lower moral disengagement scores, higher RCR knowledge, and identifying the United States as one's nation of origin emerged as key predictors of stronger performance on the PDR. The implications of these findings for understanding the measurement of decision-making in research and future directions for research and RCR education are discussed.

Professional Decision-Making in Research (PDR): The Validity of a New Measure.

In this paper, we report on the development and validity of the Professional Decision-Making in Research (PDR) measure, a vignette-based test that examines decision-making strategies used by investigators when confronted with challenging situations in the context of empirical research. The PDR was administered online with a battery of validity measures to a group of NIH-funded researchers and research trainees who were diverse in terms of age, years of experience, types of research, and race. The PDR demonstrated adequate reliability (alpha = .84) and parallel form correlation (r = .70). As hypothesized, the PDR was significantly negatively correlated with narcissism, cynicism, moral disengagement, and compliance disengagement; it was not correlated with socially desirable responding. In regression analysis, the strongest predictors of higher PDR scores were low compliance disengagement, speaking English as a native language, conducting clinical research with human subjects, and low levels of narcissism. Given that the PDR was written at an eighth grade reading level to be suitable for use with English as a second language participants and that only one-fourth of items focused on clinical research, further research into the possible roles of culture and research ethics training across specialties is warranted. This initial validity study demonstrates the potential usefulness of the PDR as an educational outcome assessment measure and a research instrument for studies on professionalism and integrity in research.

Education, progressive muscle relaxation therapy, and exercise for the treatment of night eating syndrome. A pilot study.

Night eating syndrome (NES) is a circadian rhythm disorder in which food intake is shifted toward the end of the day, interfering with sleep. According to the biobehavioral model of NES, the disorder is the result of a genetic predisposition that, coupled with stress, leads to enhanced reuptake of serotonin, thereby dysregulating circadian rhythms and decreasing satiety. Using the biobehavioral model as a guide, we developed a brief behavioral intervention using education, relaxation strategies, and exercise to address the core symptoms of NES. In this pilot randomized controlled clinical trial, 44 participants with NES were randomly assigned to an educational group (E; n = 14), E plus progressive muscle relaxation therapy (PMR; n = 15); or PMR plus exercise (PMR Plus, n = 15). Participants received a baseline intervention with 1- and 3-week follow-up sessions. Effectiveness analyses showed that participants in all three groups evidenced significant reductions on measures of NES symptoms (p < .001), depression (p < .05), anxiety (p < .01), and perceived stress (p < .05). However, the only significant between group change was for the percent of food eaten after the evening meal, with the PMR group showing the greatest reduction (-30.54%), followed by the PMR Plus group (-20.42%) and the E group (-9.5%); only the difference between the PMR and E groups was statistically significant (p = .012). Reductions in NES scores were significantly associated with reductions on measures of depression (r = .47; p < .01) and perceived stress (r = .37; p < .05), but not anxiety (r = .26, p = ns). Results support the role of education and relaxation in the behavioral treatment of NES.

Examining the role of negative urgency in a predictive model of bulimic symptoms.

The etiological dual pathway model of bulimia nervosa suggests that dietary restraint and negative affect are significant predictors of this disorder. Negative urgency, or the tendency to act rashly in response to negative emotionality, is also associated with bulimia nervosa; however, no study has examined the role of negative urgency within the context of the dual pathway model. The purpose of this study was to investigate the relationship between bulimic symptomatology and negative urgency in the context of dietary restraint and depressive affect. Participants (N=166) were college women recruited from a private mid-western university through an online participant registry. A self-report battery assessed depressive affect, dietary restraint, negative urgency, and bulimic symptoms. Participants' height and weight were measured in-person to determine body mass index. A significant main effect of negative urgency was found after controlling for depressive affect and dietary restraint. The interaction between depressive affect and negative urgency to predict bulimic symptoms approached significance; however, no statistically significant interaction between dietary restraint and negative urgency was observed. These results provide support for the inclusion of negative urgency as a significant factor in etiological frameworks of bulimia nervosa.

The Treatment of Night Eating Syndrome: A Review and Theoretical Model.

The treatment of night eating syndrome, a disorder characterized by evening hyperphagia, morning anorexia, and insomnia, continues to gain attention with its inclusion in the DSM-V. Known treatments for NES include pharmacological, phototherapy, weight loss and dietary, and psychological interventions, which, together with the syndrome's clinical characteristics, support a treatment guiding biobehavioral model. The biobehavioral model proposes that a genetic predisposition, coupled with stress, enhances midbrain serotonin transporter (SERT) binding, which results in lower post-synaptic serotonin, dysregulating circadian rhythms and decreasing satiety. Selective serotonin reuptake inhibitors should therefore decrease SERT binding, increase postsynaptic serotonin, and restore circadian function and satiety regulation. Psychological interventions may be used to decrease stress as well as address insomnia and circadian rhythm disruptions. Dietary and behavioral interventions may produce beneficial changes in satiety as well as dysregulated eating. Avenues for future treatment outcome studies, including alternative pharmacological and combination therapies, are discussed.

Food-related advertisements and food intake among adult men and women.

Television viewing may contribute to obesity via promotion of sedentary behavior and exposure to food-related commercials. However, the mechanisms by which food-related commercials promote food intake are not well understood. Therefore, the purpose of the present study was to examine the impact of television advertisements on food intake according to sex and transportability, or the tendency to become engrossed in what one is viewing. Eighty-three undergraduate students, free of disordered eating symptoms, were stratified by sex and randomly assigned to one of three conditions (food-related advertisements, neutral advertisements, or no advertisements). They were then identified as high or low in transportability according to a median split. A significant interaction was found between advertisement condition and transportability such that those high in transportability ate more in the food than other advertisement conditions. A second interaction was found between sex and transportability with women high in transportability eating more food than women low in transportability irrespective of advertisement condition. No significant main effects of advertisement condition, sex, or transportability were found. Results suggest the importance of studying the impact of individual difference variables on the relationship between food-related advertising and food intake.

An observational study of the association between adenovirus 36 antibody status and weight loss among youth.

OBJECTIVE: Although the human adenovirus 36 (Ad-36) is associated with obesity and relative hypolipidemia, its role in pediatric weight loss treatment response is uncertain. Therefore, the primary study objective was to determine whether Ad-36 antibody (AB) status was associated with response to a pediatric weight loss program. The secondary objective was to assess the association between Ad-36 AB status and baseline lipid values. METHODS: Participants included 73 youth aged 10-17 years in a residential camp-based weight loss program. The study examined differences in baseline lipid values between Ad-36 AB+ and AB- youth as well as differences in response to treatment, including indices of body size and fitness. RESULTS: At baseline, results showed that Ad-36 AB+ youth evidenced significantly lower levels of total cholesterol and triglycerides than Ad-36 AB- youth (all p < 0.05). After 4 weeks of treatment, the Ad-36 AB+ youth showed a smaller reduction in BMI percentile than the Ad-36 AB- youth (p < 0.05), a difference of about 0.48 kg. CONCLUSION: Ad-36 AB status showed a weak association with treatment response, but was associated with a better lipid profile. Ad-36 AB status should be assessed in studies of pediatric obesity treatment and prevention.

The relationship between body mass index and unhealthy weight control behaviors among adolescents: the role of family and peer social support.

Adolescents classified as overweight or obese are more likely to use unhealthy weight control behaviors such as skipping meals or fasting than their healthy weight peers. Adolescents with low perceived social support may be at particular risk. Therefore, the purpose of the present study was to investigate the association between adolescent overweight and obesity, indices of perceived peer and family social support, and their interaction in the use of unhealthy weight control behaviors among adolescents. The present study used data from the 2001-2002 Health Behavior in School-Aged Children collaborative survey. Participants included 4598 adolescent girls and boys in the ninth and tenth grades. Results of binary logistic regression analyses showed that obese boys and girls were more likely to use unhealthy weight control behaviors than their healthy weight peers. Boys and girls who endorsed difficult communication with their parents, low levels of parent school support, or frequent bullying were more likely to engage in unhealthy weight control behaviors than relevant comparison groups. Among girls, poor classmate relationships were associated with increased use of unhealthy weight control behaviors whereas fewer friendships were associated with decreased use. Results suggest that adolescents are at high risk for use of unhealthy weight control behaviors and would benefit from interventions to increase knowledge and social support for achieving and maintaining a healthy weight.