Body Checking and Body Image Avoidance as Partial Mediators of the Relationship between Internalized Weight Bias and Body Dissatisfaction.

Internalized weight bias is associated with body image disturbances and the development of disordered eating. The association between weight bias internalization and body dissatisfaction has proven difficult to disrupt. In order to develop more effective interventions, we must identify the behavioral targets which account for this robust association. The present study sought to examine whether body checking and body image avoidance mediate the relationship between weight bias internalization and body dissatisfaction. In total, 279 female undergraduates (Mage = 20.13, SD = 4.10) were administered a battery of survey measures. Results demonstrated that body checking partially mediates the relationship between weight bias internalization and body dissatisfaction, Z = 7.42, p < 0.001. Body image avoidance was also found to partially mediate the relationship between weight bias internalization and body dissatisfaction, Z = 70.03, p < 0.001. These findings suggest that body checking and body image avoidance may both partially account for the association between weight bias internalization and body dissatisfaction. These findings extend the existing literature on weight bias internalization by highlighting two behavioral targets for prevention and intervention efforts. Understanding these relationships has important implications for both reducing weight bias internalization and improving body dissatisfaction.

Thin, muscular, and fit-ideals: Prevalence and correlates in undergraduate women.

Objective: The current study aimed to compare endorsement of the muscular- and thin-ideals alone, as well as simultaneous endorsement of both as representative of the fit-ideal and examine potential negative correlates of each type of ideal internalization. Participants: Participants were 300 female undergraduate students. Methods: Participants completed measures of internalization of the thin- and muscular-ideals, body dissatisfaction, body checking, and body avoidance. Results: Analyses revealed that approximately 24.9% of participants endorsed scores in the upper quartile on thin-ideal internalization, and 27.4% of participants fell in the upper quartile of muscular-ideal internalization, while 10.3% endorsed high internalization of both ideals. Analyses revealed that individuals endorsing only the thin-ideal reported significantly higher levels of body dissatisfaction and body avoidance than those endorsing the fit-ideal. Conclusions: Overall, findings suggested that thin- and muscular-ideal internalization present different patterns of association depending on whether an individual endorses one or both of these body ideals.

Patient perceptions of blind and open weighing in treatment for eating disorders.

Little is known about patients' perceptions toward open and blind weighing for eating disorders. Upon admission to a partial hospitalization program, 35 child/adolescent patients, 55 adult patients, and 36 parents of child/adolescent patients completed questionnaires assessing attitudes toward open and blind weighing. Participants perceived blind weighing as more effective in the short term. No differences emerged on measures assessing preference, credibility, or long-term effectiveness. Relative to adults, parents preferred blind weighing, and child/adolescents perceived blind weighing as more credible. On a forced-choice question, a majority of adults, about half of children/adolescents, and a minority of parents preferred open weighing over blind weighing. There was a positive association between past treatment experience and current attitudes about weighing. Results suggest that individuals enter treatment with variable attitudes about weighing procedures for eating disorders, and may develop more favorable attitudes toward the practice they receive in treatment.

Caregiver accommodation in adolescents with avoidant/restrictive food intake disorder and anorexia nervosa: Relationships with distress, eating disorder psychopathology, and symptom change.

OBJECTIVE: The role of family and caregiver accommodation is a well-defined maintenance factor for anxiety disorders and OCD. Family accommodation for patients with eating disorders is beginning to be described and characterized, but gaps in the literature remain. The current project compares levels of accommodation in families of those with anorexia nervosa (AN) to those with avoidant/restrictive food intake disorder (ARFID). It additionally establishes whether accommodation changes over the course of treatment and the extent to which these changes are related to changes in eating disorder pathology. METHODS: A total of 39 adolescents with ARFID and 59 with AN presenting to a partial hospitalization program were included, with measures completed at intake and discharge. RESULTS: Caregivers of adolescents with AN and those with ARFID reported similar levels of accommodation, with the exception of the Reassurance Seeking subscale of the Accommodation and Enabling Scale for Eating Disorders (AESED). Additionally, accommodation decreased significantly from intake to discharge for both patient groups. Intake AESED scores were also significantly related to caregiver distress, and changes in AESED scores were related to decreases in relevant eating disorder psychopathology for both groups. CONCLUSIONS: The results of the current study highlight the importance of considering family accommodation for ARFID patients and point to the need for future research to capture changes in accommodation over the course of treatment in relation to the delivery of evidence-based interventions and subsequent changes in ED symptoms.

Appearance-focused media use as a moderator of the relationship between fear of fat and weight bias: an exploratory study.

PURPOSE: Previous research has found that fear of fat, or the fear of gaining weight, is fairly common within both normative and clinical populations. Similarly, weight bias, or biased attitudes directed at obese individuals, has been found across multiple segments of society. A common link shared between fear of fat and weight bias is the inherent emphasis on anti-fat feelings. Previous research has demonstrated an anti-fat bias within media content. Therefore, the purpose of the current research is to examine exposure to appearance-focused media as a moderator of the relationship between fear of fat and weight bias. METHODS: One hundred and eighty-seven female participants (Mage = 21.05, MBMI = 22.60) were administered a battery of assessments, including the Goldfarb Fear of Fat Scale and the Universal Measure of Bias of Fat Scale. Participants were also asked to report their frequency of exposure to appearance-focused media (TV and magazines). RESULTS: Results of this study suggest that appearance-focused media partially moderated the relationship between fear of fat and weight bias. CONCLUSIONS: This suggests the messages portrayed by the media may be strengthening the relationship between fear of gaining weight and discrimination directed at obese individuals. Understanding this relationship has important implications for reducing weight stigma. LEVEL OF EVIDENCE: Level V, cross-sectional descriptive study.

Examining the impact of social media on mood and body dissatisfaction using ecological momentary assessment.

Objective: To assess the effects of social media consumption on body dissatisfaction and negative affect using ecological momentary assessment, a method of assessment over time in the participants' naturalistic environment. Participants: Woman college students (N = 30) from a large public university participated in the study in Fall 2015. Methods: Participants were contacted via their smartphones five times per day for five days and asked to complete a battery of measures which assessed social media use, body dissatisfaction, and negative affect. Results: Results demonstrated that the number of social media sites visited was a significant predictor of body dissatisfaction while time spent using social media was not. The number of sites visited and time spent on social media were both significant predictors of general negative affect, sadness, and guilt. Conclusions: Results demonstrate the negative impact that social media use can have on body dissatisfaction and negative affect.

Personality Variables and Eating Pathology.

Personality variables have long been implicated in the onset and maintenance of eating disorders, as well as in symptom divergence between anorexia nervosa and bulimia nervosa. Clinical observations are broadly supported by the data, with restricting anorexia nervosa associated with higher levels of constraint and Persistence, and binge-purge behaviors linked to the tendency to take impulsive action when emotionally distressed. Considerable heterogeneity is found within diagnostic categories, however, suggesting that different personality structures may predispose individuals to develop disordered eating through alternative pathways.

Risk and Protective Factors of Alcohol Use Identified by Community Providers and Stakeholders in Hawai'i: Qualitative Data Analysis.

The purpose of this study was to identify community providers' perspectives on risk and protective factors for youth alcohol use in Hawai'i to inform future trainings of providers. A total of 104 providers within communities and prevention organizations in Hawai'i were asked to list risk and protective factors for underage drinking in each of the socioecological levels (individual, family, community, and society). The majority of participants were female (66.3%). Overall, 507 risk and protective factors were listed. There were significantly more risk factors identified (54.8%) than protective factors (45.2%). Participants identified significantly fewer society level risk and protective factors than all other levels. The top three overall themes identified by participants were resources (8.3%), peer influence (7.7%), and family function (6.9%). These results not only provide information about how providers conceptualize substance abuse, but may also indicate that it is necessary to continue training providers in how to identify society level factors influencing individuals' substance use. It is recommended that more research should be conducted with community providers in Hawai'i to understand the attitudes about prevention in the community. Such research may allow for improvements in prevention strategies by providing a larger picture of substance use in the community.

Guanfacine treatment for prefrontal cognitive dysfunction in older participants: a randomized clinical trial.

This study evaluated the effect of the alpha-2A-adrenoceptor agonist guanfacine on prefrontally mediated cognitive functions, as well as quality of life and global function in healthy older participants. One hundred twenty-three participants aged 75 years and older were randomly assigned to guanfacine 0.5 mg, 0.1 mg, or placebo daily for 12 weeks. The primary outcome measure was the change in z-score for 6 prefrontal executive function tasks over 12 weeks (PEF6). Neither dose of guanfacine improved PEF6 z-score relative to placebo. The rate of mean change (95% confidence interval) in PEF6 z-score over 12 weeks was 0.270 (0.159, 0.380) for placebo, compared with 0.121 (0.011, 0.232) for guanfacine 0.1 mg (p = 0.06, compared to placebo) and 0.213 (0.101, 0.324) for 0.5 mg (p = 0.47). Neither dose of guanfacine improved the quality of life or global function relative to placebo. Among common adverse events, only dry mouth was significantly more frequent on guanfacine compared to placebo. Guanfacine failed to ameliorate prefrontal cognitive function in older individuals, who were cognitively normal for age.

Loss of Control Over Eating Scale (LOCES): Validation in undergraduate men and women with and without eating disorder symptoms.

The present study aimed to further validate the Loss of Control Over Eating Scale (LOCES) for use with undergraduate men and women with and without eating disorder (ED) symptoms. A total of 261 participants completed the LOCES and the Eating Disorder Examination - Questionnaire (EDE-Q) and were identified as non-clinical or having probable ED symptomatology based on previously used EDE-Q cutoff scores. Results indicated that the LOCES and its subscales were significantly associated with and a significant predictor of global ED pathology and binge episode frequency. The LOCES behavioral subscale appeared to be a stronger predictor of episode frequency compared to other subscales. The ED pathology groups reported significantly higher LOCES scores compared to the non-ED pathology groups. Binary logistic regression analyses revealed that the LOCES was able to accurately distinguish between those with ED pathology and those without ED pathology in the majority of cases. Findings from the present study suggest that the LOCES is highly predictive of ED pathology, strongly associated with ED cognitions and behaviors, and an accurate index for global eating disorder pathology. Future directions for research are discussed.

Eating disorder features and quality of life: Does gender matter?

PURPOSE: This study examined whether gender moderates the associations between eating disorder features and quality-of-life impairment and whether eating disorder features can explain gender differences in quality of life in a sample of undergraduate students. METHODS: The SF-12 Physical and Mental Component Summary Scales were used to measure health-related quality of life (HRQoL), and the Eating Disorders Examination Questionnaire (EDE-Q) was used to quantify eating disorder behaviors and cognitions. These self-report forms were completed by undergraduate men and women (n = 709). RESULTS: Gender was a significant predictor of mental HRQoL, such that women in this sample reported poorer mental HRQoL than men. Eating disorder cognitions were the strongest predictor of undergraduate students' mental and physical HRQoL, while binge eating negatively predicted their physical HRQoL only. Gender was not found to moderate the associations between eating disorder features and HRQoL, and eating disorder cognitions were found to mediate the association between gender and mental HRQoL such that a proportion of the difference between undergraduate men and women's mental HRQoL was attributable to eating disorder cognitions. CONCLUSION: This study provided further evidence of the significant impact of eating disorder features, particularly eating disorder cognitions, on HRQoL. The finding that gender did not moderate the relationships between eating disorder features and HRQoL indicates the importance of investigating these features in both men and women in future research.

A phase Ib multiple ascending dose study of the safety, tolerability, and central nervous system availability of AZD0530 (saracatinib) in Alzheimer's disease.

INTRODUCTION: Despite significant progress, a disease-modifying therapy for Alzheimer's disease (AD) has not yet been developed. Recent findings implicate soluble oligomeric amyloid beta as the most relevant protein conformation in AD pathogenesis. We recently described a signaling cascade whereby oligomeric amyloid beta binds to cellular prion protein on the neuronal cell surface, activating intracellular Fyn kinase to mediate synaptotoxicity. Fyn kinase has been implicated in AD pathophysiology both in in vitro models and in human subjects, and is a promising new therapeutic target for AD. Herein, we present a Phase Ib trial of the repurposed investigational drug AZD0530, a Src family kinase inhibitor specific for Fyn and Src kinase, for the treatment of patients with mild-to-moderate AD. METHODS: The study was a 4-week Phase Ib multiple ascending dose, randomized, double-blind, placebo-controlled trial of AZD0530 in AD patients with Mini-Mental State Examination (MMSE) scores ranging from 16 to 26. A total of 24 subjects were recruited in three sequential groups, with each randomized to receive oral AZD0530 at doses of 50 mg, 100 mg, 125 mg, or placebo daily for 4 weeks. The drug:placebo ratio was 3:1. Primary endpoints were safety, tolerability, and cerebrospinal fluid (CSF) penetration of AZD0530. Secondary endpoints included changes in clinical efficacy measures (Alzheimer's Disease Assessment Scale - cognitive subscale, MMSE, Alzheimer's Disease Cooperative Study - Activities of Daily Living Inventory, Neuropsychiatric Inventory, and Clinical Dementia Rating Scale - Sum of Boxes) and regional cerebral glucose metabolism measured by fluorodeoxyglucose positron emission tomography. RESULTS: AZD0530 was generally safe and well tolerated across doses. One subject receiving 125 mg of AZD0530 was discontinued from the study due to the development of congestive heart failure and atypical pneumonia, which were considered possibly related to the study drug. Plasma/CSF ratio of AZD0530 was 0.4. The 100 mg and 125 mg doses achieved CSF drug levels corresponding to brain levels that rescued memory deficits in transgenic mouse models. One-month treatment with AZD0530 had no significant effect on clinical efficacy measures or regional cerebral glucose metabolism. CONCLUSIONS: AZD0530 is reasonably safe and well tolerated in patients with mild-to-moderate AD, achieving substantial central nervous system penetration with oral dosing at 100-125 mg. Targeting Fyn kinase may be a promising therapeutic approach in AD, and a larger Phase IIa clinical trial of AZD0530 for the treatment of patients with AD has recently launched. TRIAL REGISTRATION: ClinicalTrials.gov: NCT01864655. Registered 12 June 2014.