Making mental health a priority on college campuses: implementing large scale screening and follow-up in a high enrollment gateway course.

OBJECTIVES: We sought to evaluate a universal mental health screening program for undergraduate students using graduate student clinicians and online interviewing tools. Participants: Participants included 455 undergraduate students. Data were collected from October 2017 through January 2018. Methods: Participants completed a self-report mental health screening questionnaire. Students scoring "at risk" on any subscale were invited to participate in individual online follow-up interviews to assess risk level and provide referral information. Results: A majority of participants scored in an "at risk" range on at least one subscale. Follow-up interviews were conducted for 40% of students "at risk" and 33% of those interviewed were referred to the university counseling center. Participants' perceptions of campus mental health priorities improved over a three-month period. Conclusions: A pilot universal campus mental health screening using graduate student clinicians resulted in a meaningful number of referrals and enhanced perception that the university cared about student mental health.

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.

Evaluating the effectiveness of ecological momentary assessment and intervention targeting body checking behaviors.

This study investigated the efficacy of using ecological momentary assessment and intervention (EMA/EMI) to target body checking behaviors. Body checking has been shown to increase body dissatisfaction and play a role in eating disorders, but few treatments specifically targeting body checking have been empirically evaluated. Forty-four female undergraduates who reported engaging in frequent body checking behaviors participated in a five-day study wherein they were assessed five times a day via smart phone. On the final two days of the study, intervention messages were sent containing cognitive-behavioral strategies for decreasing body checking. Body checking behaviors increased within each day, but decreased across the five day intervention period. Pretest to posttest analyses found healthy improvements in a number of body image related constructs. These results highlight that 1) body checking appears to increase throughout the day, and 2) targeting body checking behaviors through brief EMA/EMI may be a useful clinical tool.

Short-term changes in affective, behavioral, and cognitive components of body image after bariatric surgery.

BACKGROUND: Many bariatric surgery candidates report body image concerns before surgery. Research has reported post-surgical improvements in body satisfaction, which may be associated with weight loss. However, research has failed to comprehensively examine changes in affective, behavioral, and cognitive body image. OBJECTIVES: This research examined (1) short-term changes in affective, behavioral, and cognitive components of body image from pre-surgery to 1- and 6-months after bariatric surgery, and (2) the association between percent weight loss and these changes. SETTING: Participants were recruited from a private hospital in the midwestern United States. METHODS: Eighty-eight females (original N = 123; lost to follow-up: n = 15 at 1-month and n = 20 at 6-months post-surgery) completed a questionnaire battery, including the Body Attitudes Questionnaire, Body Checking Questionnaire, Body Image Avoidance Questionnaire, and Body Shape Questionnaire, and weights were obtained from patients' medical records before and at 1- and 6-months post-surgery. RESULTS: Results indicated significant decreases in body dissatisfaction, feelings of fatness, and body image avoidance at 1- and 6-months after bariatric surgery, with the greatest magnitude of change occurring for body image avoidance. Change in feelings of fatness was significantly correlated with percent weight loss at 6-months, but not 1-month, post-surgery. CONCLUSIONS: These findings highlight the importance of examining short-term changes in body image from a multidimensional perspective in the effort to improve postsurgical outcomes. Unique contributions include the findings regarding the behavioral component of body image, as body image avoidance emerges as a particularly salient concern that changes over time among bariatric surgery candidates.

Examination of body checking, body image dissatisfaction, and negative affect using Ecological momentary assessment.

Research has shown that non-clinical women, particularly those with high body concern, engage in frequent body checking behaviors. The purpose of this study was to use ecological momentary assessment (EMA) to examine the frequency and correlates of body checking behavior, including its association with body image dissatisfaction and negative affect, in non-clinical women with high body concern. Undergraduate female participants with high body concern (n=22) were assessed five times per day for five days via text messages sent to their smart phones. During each assessment, participants reported the number of times they engaged in eight different body checking behaviors and their current level of negative affect and body dissatisfaction. After aggregation, a total of 3064 body checking behaviors were reported by the sample during the five-day period. All participants reported engaging in body checking at least once per day, with a mean of 27.85 checking behaviors per day. Hierarchical Linear Modeling revealed that body checking significantly predicted both body dissatisfaction and negative affect. These results provide preliminary support for the cognitive behavioral theory of eating disorders, suggesting that as women engage in more frequent body checking behaviors, they also experience higher levels of body dissatisfaction and negative affect.

An examination of body tracing among women with high body dissatisfaction.

Within eating disorder treatment programs, a body tracing activity is often used to address body dissatisfaction and overestimation of body size; however, the effects of this activity have never been empirically evaluated. This research examined the effects of body tracing on body dissatisfaction and mood among 56 female participants assigned to either a body tracing or control group. Scores were collected on trait body dissatisfaction and a series of Visual Analogue Scales (VAS). Results showed that trait body dissatisfaction moderated the relationship between group and levels of state appearance dissatisfaction and anxiety. These results suggest that individuals experiencing higher levels of trait body dissatisfaction demonstrated greater state body dissatisfaction following participation in the body tracing activity. Individuals with lower trait body dissatisfaction experienced greater anxiety after drawing a human body. These findings have potential implications for the use of this strategy in the treatment of eating disorder patients.

Readiness to change dietary restriction predicts outcomes in the eating disorders.

This study examined the relationship between readiness and motivation to change eating disorder symptoms and clinical outcomes during and following intensive residential eating disorder treatment. Sixty-four women completed the Readiness and Motivation Interview (RMI) at baseline, and a subset of participants were reassessed at post-treatment (n=45) and at 6 month follow-up (n=38). The RMI provides readiness scores for each of four symptom domains: restriction, cognitive, bingeing, and compensatory strategies. RMI scores were used to predict decision to enroll in treatment, dropout, symptom change following treatment, and maintenance of symptom change at six-month follow-up. The extent to which participants did not want to make changes to their dietary restriction at baseline (restriction precontemplation) was the most consistent predictor of short-term clinical outcome. The extent to which participants reported changing their restriction for themselves versus others (restriction internality) predicted outcome at 6-month follow-up. These preliminary findings suggest that assessing client readiness and motivation to change dietary restriction is most useful in predicting short and long-term clinical outcomes.

Development of the body checking questionnaire: a self-report measure of body checking behaviors.

OBJECTIVE: The purpose of this study was to develop a brief self-report inventory to assess body checking behaviors. METHOD: Using exploratory and confirmatory factor analyses, the 23-item Body Checking Questionnaire (BCQ) was developed. The BCQ measures the global construct of body checking behaviors with three correlated subfactors that assess checking related to overall appearance, checking of specific body parts, and idiosyncratic checking rituals. RESULTS: The BCQ was found to have good test-retest reliability (.94) and the subfactors had good internal consistency (.88, .92, and .83). The measure correlated highly with other measures of negative body image and eating disorders, demonstrating its concurrent validity. Additionally, the BCQ was found to differentiate normal controls and eating disorder patients, as well as nonclinical participants scoring high and low on a measure of concern with body size and dieting. DISCUSSION: Due to the potential role of ritualistic body checking in the maintenance of body dissatisfaction by directing excessive attention to body shape/weight, the BCQ may prove to be a useful clinical tool in the assessment and treatment of eating disorder patients.

Pretrial publicity and civil cases: a two-way street?

Published pretrial publicity (PTP) research has been conducted almost exclusively with criminal cases and has focused on PTP that is detrimental to the defense. The current research examined the effects of PTP in a civil case to determine if PTP can have a biasing effect against either the defendant or the plaintiff in civil litigation. In Experiment 1, participants exposed to PTP biased against the defendant were more likely to reach a liable verdict than participants who read a control article or PTP biased against the plaintiff Experiment 2 demonstrated that a judicial admonition did not reduce the biasing effect of PTP about a civil defendant. However, participants given the admonition both before and after the trial evidence viewed the defendant as less culpable than participants given the admonition after the trial only or not at all. The implications for the legal system are discussed.

Development and validation of the food-craving inventory.

OBJECTIVE: The primary aim of this study was to develop and validate the Food-Craving Inventory (FCI), a self-report measure of specific food cravings. RESEARCH METHODS AND PROCEDURES: In a preliminary study, participants (n = 474) completed the initial version of the FCI. The results from this study were used in developing the revised FCI. Participants (n = 379) completed the revised FCI in the primary study designed to develop a self-report measure of specific food cravings. RESULTS: Common factor analysis yielded four conceptual factors (subscales) that were interpreted as high fats, sweets, carbohydrates/starches, and fast-food fats. Confirmatory factor analysis found that the four factors could be modeled as dimensions (or first-order factors) of a higher order construct-food craving. Test-retest and internal consistency analyses indicated good reliability for the total score and each of the subscales. Subscale scores were compared with scores on the Three Factor Eating Questionnaire and a conceptual measure of food craving. We found support for the content, concurrent, construct, and discriminant validity of the FCI. DISCUSSION: The FCI was found to be a reliable and valid measure of general and specific food cravings. The FCI can be used in research related to overeating and binge eating. Also, it may be useful in treatment studies that target obesity and/or food cravings.

Perceived weight status in normal weight and overweight women.

The current study sought to assess women's knowledge of what objectively constitutes underweight, normal weight, or overweight for a given height, and how this knowledge is affected by a woman's own weight status. A total of 31 normal weight women and 20 overweight women were asked to provide predictions of weight ranges for a female 4 feet 11 in. to 6 feet 2 in. in height for the following categories: extremely underweight, underweight, normal weight, overweight, obese, and extremely obese. Each participant completed the questionnaire for all heights, although the critical values for each participant were the weight ranges given for their own height category. These predictions were then compared to the participants' own weight status using Body Mass Index (BMI). Results suggest that normal weight women tend to believe that women must be smaller in order to be classified as normal weight, overweight, or obese when compared to the objective BMI categories used by physicians and researchers. In other words, the normal weight participants underestimated the BMI ranges for the normal weight, overweight, and obese categories. Overall, the overweight participants were fairly accurate in their BMI predictions for the different weight categories. One implication of these findings is that normal weight women may have a bias toward overestimating their weight to be within an overweight range. The need for health care marketing efforts to increase awareness of objective weight categories is addressed.