Daily Relationship Functioning and Disordered Eating Behaviors Among Sexual Minority Women in Same-Sex Relationships.

BACKGROUND AND PURPOSE: The present study aimed to examine associations between different types of relationship functioning and disordered eating behaviors (DEBs) in the everyday lives of sexual minority women in same-sex relationships-an at-risk population that has not been assessed in this context. METHODS: Participants included 321 young sexual minority women (Mage = 27.56, SD = 3.67) in same-sex relationships who completed surveys assessing their daily relationship functioning and DEB use each day for a 14-day daily diary period. Multilevel structural equation modeling was used to examine daily-, person-, and couple-level associations among women's daily relationship functioning (general relationship functioning, positive and negative relational behaviors they and, separately, their partners engaged in) and DEBs (overeating, loss of control eating, emotional eating, and dietary restriction). RESULTS: Results generally indicated that more positive and less negative daily relationship functioning across all assessed constructs was associated with less same-day emotional eating. In contrast, associations between all daily relationship functioning constructs and loss of control eating were not significant, nor were any relationship functioning-DEB associations at the couple level. More circumscribed patterns of association were identified for associations between the relationship functioning constructs, and overeating and dietary restriction. CONCLUSIONS: Collectively, these findings provide insight into how aspects of daily relationship functioning map onto sexual minority women's daily engagement in DEBs that are linked to poor health long-term, and directions for future research and clinical practice that may warrant consideration moving forward to help advance the evidence-base and care for this historically overlooked and underserved population.

The present study examined associations between different types of relationship functioning (e.g., general relationship functioning, positive and negative relational behaviors that participants and their partners engaged in during their interactions with one another) and disordered eating behaviors (DEBs) in the everyday lives of sexual minority women in same-sex relationships. Results generally indicated that on days when women reported more positive and less negative daily relationship functioning, they also reported less emotional eating that day. In contrast, associations between different types of daily relationship functioning and loss of control eating were not significant. Furthermore, associations between different types of daily relationship functioning relative to overeating and dietary restriction varied based on the type of relationship functioning and DEB under consideration. Collectively, these findings provide insight into how different types of daily relationship functioning map onto sexual minority women's daily engagement in DEBs that are linked to poor health long-term. These findings also provide directions for future research and clinical practice that may warrant consideration moving forward to help advance the evidence base and care for this historically overlooked and underserved population.

Expanding a Behavioral View on Digital Health Access: Drivers and Strategies to Promote Equity.

The potential and threat of digital tools to achieve health equity has been highlighted for over a decade, but the success of achieving equitable access to health technologies remains challenging. Our paper addresses renewed concerns regarding equity in digital health access that were deepened during the COVID-19 pandemic. Our viewpoint is that (1) digital health tools have the potential to improve health equity if equitable access is achieved, and (2) improving access and equity in digital health can be strengthened by considering behavioral science-based strategies embedded in all phases of tool development. Using behavioral, equity, and access frameworks allowed for a unique and comprehensive exploration of current drivers of digital health inequities. This paper aims to present a compilation of strategies that can potentially have an actionable impact on digital health equity. Multilevel factors drive unequal access, so strategies require action from tool developers, individual delivery agents, organizations, and systems to effect change. Strategies were shaped with a behavioral medicine focus as the field has a unique role in improving digital health access; arguably, all digital tools require the user (individual, provider, and health system) to change behavior by engaging with the technology to generate impact. This paper presents a model that emphasizes using multilevel strategies across design, delivery, dissemination, and sustainment stages to advance digital health access and foster health equity.

Affect and disordered eating behaviours in women's daily lives: The comparative explanatory roles of distinct momentary emotion dysregulation dimensions.

OBJECTIVE: The present study aimed to examine: (a) whether distinct momentary emotion dysregulation dimensions differentially mediated momentary associations between affect and disordered eating behaviours (DEBs) in the natural environment; (b) whether these associations differed based on affect, emotion dysregulation, and DEB type. METHOD: 150 women with eating disorder pathology (Mage = 20.95, SD = 4.14) completed 4 surveys targeting affect, emotion dysregulation, and DEBs each day for a 10-day ecological momentary assessment period. Multilevel structural equation models examined whether four momentary emotion dysregulation dimensions (difficulties with emotional and behavioural modulation, lack of emotional acceptance, awareness, and clarity) mediated momentary associations between negative and positive affect (PA), and loss of control eating, overeating, and dietary restriction. RESULTS: Momentary difficulties with emotional and behavioural modulation mediated momentary associations between negative affect (NA) and women's loss of control eating and overeating. These findings did not extend to PA, the other emotion dysregulation dimensions, or dietary restriction. CONCLUSIONS: Collectively, these results support emotional and behavioural modulation deficits in the natural environment as potential transdiagnostic maintenance mechanisms of overeating and loss of control eating. These findings also support the potential benefits of targeting NA and this type of emotion dysregulation in existing and novel real-time eating disorders interventions.

Daily weight stigma experiences, and disordered and intuitive eating behaviors among young adults with body dissatisfaction.

OBJECTIVE: The present study aimed to extend naturalistic weight stigma research by examining the following aims among young adults with body dissatisfaction and varied body mass indices (BMIs): (1) characterize the frequency of individuals' daily weight stigma experiences, and contextual variations, over a 14-day period; (2) examine whether BMI moderated daily associations between weight stigma experiences relative to eating disorder symptoms and intuitive eating behaviors. METHOD: Women (n = 174) and men (n = 24) completed a 14-day daily diary protocol. Concurrent and time-lagged multilevel models examined associations between daily weight stigma, and eating disorder and intuitive eating behaviors among women only due to the small subsample of men. RESULTS: Over the 14-day assessment, 43.94% (n = 87) of participants experienced weight stigma. Weight stigma rates varied based on how, where, and by whom weight stigma was expressed, and via BMI. Further, among women, multiple concurrent within-person associations were identified between women's daily weight stigma experiences and daily eating disorder symptoms (skipping meals, binge eating, and body dissatisfaction). Time-lagged associations also showed that women's weight stigma experiences on a given day were associated with a greater likelihood that they would limit the amount of food they consumed the next day. These associations did not differ via women's BMIs. DISCUSSION: Collectively, these findings provide important information on how weight stigma experiences unfold in daily life among individuals with body dissatisfaction and varied BMIs, and the proximal and more enduring impact of women's daily weight stigma experiences on their use of multiple adverse eating behaviors that can promote poor health. PUBLIC SIGNIFICANCE: The present findings provide important information on how, where, and by whom weight stigma experiences unfold in daily life among young adults with body dissatisfaction and varied body weights, as well as the proximal and more enduring impact of women's daily weight stigma experiences on their use of a variety of adverse eating behaviors that can promote poor health.

Emotion word use patterns and eating disorder symptoms: Considering the circumplex model of affect and basic emotions theory.

OBJECTIVE: No prior research has examined whether the types of emotion words individuals use to describe their affective experiences cluster along affective dimensions inherent within leading affect theories, or how such emotion word use maps onto eating disorder (ED) symptoms. METHOD: To address these gaps, latent profile analysis was used to empirically-identify groups of young adults (N = 352) by how often they use emotion words characterized by the circumplex model of affect's valence-arousal dimensions and basic emotions theory's basic versus complex emotion word categorizations. Auxiliary analyses examined differences in groups' ED symptoms (binge eating, purging, restricting, excessive exercising, muscle building, body dissatisfaction, and cognitive restraint). RESULTS: The 5-profile valence-arousal model and 4-profile basic-complex model were the best-fitting theoretically-supported solutions. Valence-arousal profiles with greater negative affect valence generally exhibited worse ED pathology than others, whereas profiles with greater positive affect valence produced inconsistent risk- and protective-factor relations with distinct ED symptoms. Basic-complex profiles characterized by frequent use of both basic and complex emotion words generally had the greatest ED severity, and profiles with greater basic emotion word use exhibited elevated binge eating. DISCUSSION: Individual-differences in young adults' emotion word use patterns, versus sample-level averages only, warrant further consideration in ED prevention and research. PUBLIC SIGNIFICANCE: The present findings suggest that young adults differ in the types of words they use to describe their emotional experiences, and that these unique emotion word use patterns are linked to distinct eating disorder symptoms. These sources of variation warrant further consideration in eating disorders prevention efforts and future research seeking to advance affect-based eating disorders theories.

Criterion Validity of Protective Behavioral Strategies for Alcohol Consumption among College Students: Comparison across Two Measures.

BACKGROUND: Protective behavioral strategies (PBS), or behaviors used to reduce harm associated with alcohol use, are often associated with lower levels of alcohol consumption, lower engagement in high-risk drinking behaviors, and fewer alcohol-related consequences. Although the majority of studies have found significant associations between higher PBS use and lower consumption or consequences, some studies have found nonsignificant or even positive associations. One explanatory hypothesis is that the mixed findings are due to differential content in PBS measures. OBJECTIVES: The current study examined the criterion validity of two widely-used PBS measures, the PBSS and the SQ. In a multi-institution online study assessing alcohol outcomes, college drinkers were randomly assigned to complete one PBS measure. Both measures had the same response options to standardize assessment and focus on content. RESULTS: Findings suggest both measures of PBS are consistently predictive of alcohol outcomes among college drinkers, across multiple subpopulations (i.e., strength of association was not moderated by sex, race, or drinking level). CONCLUSIONS/IMPORTANCE: Some PBS subscales were more impactful than others, suggesting researchers may want to choose which PBS scale to use based on outcomes of interest, or after determining if alternatives to drinking is an important facet of PBS for the research questions being examined. Moreover, the differential findings for subscales suggest that prevention and intervention programs incorporating PBS should focus on strategies that avoid high-risk scenarios (e.g., avoiding shots or drinking games), rather than general strategies of self-pacing.

Temporal Sequencing of Naturalistic Associations Between Body Satisfaction and Physical Activity: An Ecological Momentary Assessment Study Among Women in Midlife With Elevated Cardiovascular Risk.

The goal of the present study was to examine naturalistic associations between body satisfaction and physical activity (PA) among women in midlife. Women 40-60 years of age with cardiovascular risk factors (e.g., hypertension; N = 75; Mage = 51.63) responded to five surveys per day for 10 days while accelerometer-derived PA measurements were collected continuously. PA parameters included cognitive determinants (PA motivation and intentions) and accelerometer-measured PA behavior (sedentary behavior, light-intensity PA, and moderate to vigorous PA). Multilevel models indicated that associations between body satisfaction and everyday PA differed across PA determinants, time frames (concurrent and prospective), and levels (momentary, daily, and person). For example, positive bidirectional associations were identified between women's daily body satisfaction and PA motivation, whereas greater momentary light-intensity PA (but not moderate to vigorous PA) was unidirectionally associated with greater body satisfaction at a subsequent prompt. These findings provide insight into how associations between body satisfaction and PA unfold in the daily lives of women in midlife and highlight the complexities of these associations.

Perceived Stress, Religiosity, and Substance Use Among African American and Latinx College Students with Asthma in the USA.

This study examined associations among perceived stress, religiosity, and substance use in African American and Latinx college students with asthma. Participants included 194 college students with asthma (18-20 years, 63.4% African American, 21.1% Latinx). Eligible students completed an online questionnaire that included measures of asthma control, perceived stress, religiosity, alcohol misuse, and last 30-day tobacco use and marijuana use. Over one-quarter (25.3%) of participants reported using tobacco and 31.9% reported using marijuana in the past 30 days. Perceived stress and religiosity were each independently associated with multiple indicators of substance use. Asthma control moderated associations between religiosity and tobacco use in the past 30 days (b = - .014, p = .002), such that the association between religiosity and tobacco use was stronger among those with better asthma control. Participant gender significantly moderated the association between perceived stress and alcohol misuse (b = - .099, p = .029); a stronger, positive association between stress and alcohol misuse was found among men. Students' perceived stress levels were associated with marijuana use in the past 30 days and high alcohol misuse. Religiosity was inversely linked to substance use. There is a need for healthcare providers to recognize and focus on substance use prevention specifically among African American and Latinx college students with asthma.

Parent-adolescent dyadic associations among weight misperceptions, weight change behaviors, and dietary intakes.

Prior research has shown that larger differences between individuals' actual and perceived bodily states are associated with their engagement in weight change behaviors. However, it remains unknown whether these intrapersonal associations extend to the parent-adolescent dyadic level. To address this research gap, the present study examined associations between parents' and adolescents' weight misperceptions (discrepancies between individuals' self-reported body mass indices and perceived weight statuses) relative to participants' own and their dyadic partners' weight change behaviors and dietary intakes. Participants included a large community sample of parent-adolescent dyads (N = 1,606 dyads) who completed the National Cancer Institute's FLASHE Study. Actor-partner interdependence models examined dyadic associations among participants' weight misperceptions (over- and under-perceptions) relative to their own and their dyadic partners' general weight change behaviors (current weight loss and gain behaviors), and low nutrient (e.g., processed foods) and nutrient-dense (e.g., fruits/vegetables) dietary intakes. Multiple intrapersonal and cross-dyad member associations were identified that varied based on the direction of weight misperceptions, the weight control behavior type, and whether the dyadic member was a parent or adolescent. For example, adolescents' weight under-perception was associated with a lower likelihood of their own, but not their parents', current weight loss behavior use, whereas parents who exhibited weight under-perception were less likely to report weight loss behaviors at the intrapersonal level and were less likely to have adolescents who reported weight loss behaviors. These results suggest that associations among weight misperceptions and weight control behaviors within the parent-adolescent dyadic context are complex, and that both inter- and intra-individual processes are implicated in these associations. The impact of these perceptual influences on parent-adolescent dyads' use of both healthy and disordered eating behaviors warrants further exploration in future research.

Family meals, positive versus negative emotion suppression, and emotional eating: examining adolescent-parent dyadic associations.

PURPOSE: The present study aimed to extend existing research by examining adolescent-parent dyadic associations among adaptive and maladaptive family meal characteristics, positive and negative emotion suppression, and emotional eating. METHOD: Participants included a community-based sample of adolescents and parents (N = 1646 dyads) who participated in the National Cancer Institute's Family Life, Activity, Sun, Health, and Eating Study. Dyad members both completed measures assessing family meal characteristics (family meal importance beliefs, family mealtime television watching), emotion suppression, and emotional eating via online surveys. Actor-partner interdependence models were used to examine dyadic associations among the assessed family meal characteristics, positive and negative emotion suppression, and emotional eating. RESULTS: Multiple within-person (e.g., adolescent-adolescent, parent-parent), cross-dyad member (e.g., adolescent-parent, parent-adolescent), and divergent adolescent versus parent dyadic effects were identified that differed based on the extent to which participants suppressed positive versus negative affect. For example, whereas adolescents' stronger beliefs in the importance of frequent family meals were associated with lower levels of their own suppression of positive emotions and, in turn, lower levels of both their own and their parents' emotional eating, these mediational associations were only identified at the within-person (not cross-dyad member) level among parents. CONCLUSIONS: Collectively, these findings attest to the complexity of associations among the assessed risk and protective family meal characteristics, the suppression of differentially valenced emotions, and emotional eating that manifest at the adolescent-parent dyadic level. Findings also support the continued use of a family-based perspective to further the understanding of factors that are associated with emotional eating. LEVEL OF EVIDENCE: Level V, cross-sectional descriptive study.

Development and initial validation of an underreporting of Disordered Eating Behaviors Scale.

The purpose of this study was to develop the Underreporting of Disordered Eating Behaviors Scale (UDEBS) to detect attempts by respondents to underreport eating patterns that reflect symptoms of an eating disorder. In "Study 1", the scale and validity measures were administered via an online survey to 692 undergraduates. In "Study 2", these measures were administered to 810 undergraduates using a simulation design where participants were randomized to four conditions: (1) answering as truthfully as possible, or as if they are trying to hide (2) Binge Eating Disorder (BED), (3) Anorexia Nervosa (AN), or (4) Bulimia Nervosa (BN). "Study 1" results suggested that men and women have divergent UDEBS distributions and item endorsement rates; therefore, separate analyses were performed by gender. Individuals who scored above one standard deviation (SD) on the UDEBS reported less body dissatisfaction and disordered eating (ps < 0.05) than those who scored one SD below. In "Study 2" women who were instructed to hide an eating disorder reported significantly higher UDEBS scores than women instructed to answer truthfully. There were no significant differences between conditions for men. The final 15-item scale indicated that women who complied with instructions to underreport produced scores 1.45 (BN) to 1.72 (AN) times greater than the truthful responding condition. This novel scale can potentially assist in detecting women who underreport in relation to disordered eating, which may be useful in research and clinical contexts where underreporting is a concern. Future research is needed with men and clinical samples.Level I Evidence obtained from an experimental study.

Regulatory parental feeding behaviors, emotion suppression, and emotional eating in the absence of hunger: Examining parent-adolescent dyadic associations.

OBJECTIVE: The present study aimed to improve the understanding of inter- and intrapersonal processes implicated in emotional eating using a large community sample of parent-adolescent dyads. METHOD: Participants included 1823 parent and adolescent dyads who completed the National Cancer Institute's Family Life, Activity, Sun, Health, and Eating Study. Parents and adolescents each completed measures assessing parents' feeding behaviors, and participants' own emotional functioning and eating behaviors. Actor-partner interdependence models examined dyadic associations among participants' reports of parents' regulatory feeding behaviors (allowing adolescents to eat for emotional comfort purposes, controlling adolescents' "junk" food/sugary drink intakes), emotion suppression, and emotional eating in the absence of hunger. RESULTS: Multiple within-person, cross-dyad member, and divergent parent versus adolescent dyadic effects were identified that differed based on the parental feeding behavior that parents and adolescents reported on. For example, adolescents' reports that their parents regulate their "junk" food/sugary drink intakes were associated with lower levels of their own emotion suppression and, in turn, lower levels of both their own and their parents' emotional eating, whereas parents' reports that they regulate their adolescents' "junk" food/sugary drink intakes were associated with higher levels of their own emotion suppression and emotional eating. CONCLUSIONS: These findings underscore the complex interconnectivity among parental feeding behaviors, emotion dysregulation, and emotional eating within the parent-adolescent dyadic context, and support the use of preventive disordered eating interventions focused on enhancing healthy parent feeding behaviors and adaptive emotion regulation skills from a family-based perspective.

Measurement of the influences of social processes in appetite using ecological momentary assessment.

Obesity and eating disorders are serious health concerns that both involve dysregulated eating patterns, including binge eating and emotional eating. Though social processes and appetite dysregulation have been shown to predict dysregulated eating separately, limited research has examined the potential link between social processes and appetite in daily life. The purpose of the present study was to examine the association between naturally occurring social processes previously linked with dysregulated eating and appetite using ecological momentary assessment (EMA). Thirty women with binge-eating pathology completed five semi-random EMA surveys a day for 14 days. The EMA surveys included measures of social processes that occurred between surveys (i.e., interpersonal problems, body social comparisons, social media use, and external pressures for thinness) and assessments of appetite at time of survey. Multilevel analyses revealed that each social process approximately 2-h prior positively predicted appetite. Further, using lagged analyses, all of the social processes approximately 4-h prior, aside from social media use, predicted appetite. Our findings suggest that social processes are important in predicting appetite among women with binge-eating pathology. Future extensions of this research that include measures of dysregulated eating are needed.

Sex and Racial Differences in Patterns of Disordered Eating and Alcohol Use.

The present study aimed to determine how young adults' use of disordered eating behaviors (DEBs) and alcohol uniquely cluster with one another, how these clusters differ by sex and race, and map onto health-related correlates. As a part of a cross-sectional study assessing college student health and experiences, female (n = 1,026), male (n = 336), White (n = 640), and Black (n = 561) young adult college students at three universities (Mage = 20.54, SD = 1.80) completed measures assessing DEBs and alcohol use, and physical and mental health. Multigroup mixture modeling was used to identify subgroups of female, male, White, and Black young adults that are characterized by different levels of DEBs (fasting, food avoidance, loss of control eating, overeating) and alcohol use (binge drinking, drinking quantity). Whether group membership relates to theoretically and clinically relevant health correlates (stress, depressive symptoms, sleep health) was examined via auxiliary analyses. Qualitative and quantitative differences were identified in the best-fitting mixture models for female (four groups), male (four groups), White (five groups), and Black (three groups) participants that suggest sex and racial variations exist in patterns of DEBs and alcohol use severity. Generally, classification in groups characterized by moderate to high probabilities of DEBs only, or the combination of moderate to high DEBs and alcohol use, was associated with worse affective concerns across sexes and races. Targeting young adults' DEBs and alcohol use via diversity-informed treatments focused on coping skill development may help promote health and well-being.

Associations among weight suppression, self-acceptance, negative body image, and eating disorder behaviors among women with eating disorder symptoms.

The present study aimed to clarify existing research that has inconsistently shown that weight suppression (differences between individuals' highest and current body weights) is associated with worse eating disorder (ED) behaviors and negative body image among women with lifetime EDs, by examining whether an understudied client-supported protective factor for ED pathology - self-acceptance - moderates these associations. Currently symptomatic women with lifetime EDs (N = 108) completed measures assessing self-acceptance and ED symptoms via an online survey. Moderated regressions examined whether self-acceptance moderated associations between weight suppression and both body image (weight/shape preoccupation, overvaluation, dissatisfaction) and ED behavior (dietary restraint, compensatory behaviors, binge eating) outcomes. Results indicated that weight suppression was associated with more severe negative body image and dietary restraint, but not compensatory behaviors or binge eating. In contrast, self-acceptance consistently emerged as a protective factor relative to all negative body image and ED behavior indices. This protective effect did not offset apparent risk factor associations between weight suppression, and negative body image and ED behavior outcomes. These results support further assessment of self-acceptance as an understudied protective factor for women's ED symptoms and as a mechanism of change in EDs intervention research. Women's weight suppression should be assessed during ED prevention initiatives.

Examining the ecological validity of the Power of Food Scale.

PURPOSE: Appetite for palatable foods may impact eating-related behaviors in everyday life. The present study evaluated the real-world predictive validity of the Power of Food Scale (PFS) using ecological momentary assessment (EMA). METHODS: 30 women who reported binge eating completed the PFS and related measures. Subsequently, during a 14-day assessment period, participants completed five daily EMA surveys of appetite and binge eating via text message and web. RESULTS: Results of generalized estimating equations showed that higher PFS scores were associated with higher momentary levels of hunger, eagerness to eat, and urge to eat but were unrelated to fullness, preoccupation with thoughts of food, and binge eating. CONCLUSION: This study supported the ecological validity of the PFS by demonstrating its association with momentary measures of appetite in everyday life using EMA. Although the PFS may not be predictive of binge eating, future research should investigate PFS as a dispositional moderator, and explore associations between the PFS and overeating (i.e., binge eating without the loss of control component) and loss of control eating in non-clinical samples. LEVEL OF EVIDENCE: Level IV, multiple time series.

Changes in disordered eating behaviors over 10 or more years: A meta-analysis.

OBJECTIVE: The present meta-analysis evaluated changes in individuals' risk of engaging in distinct disordered eating behaviors (DEBs) in the long-term. METHOD: Longitudinal studies assessing changes in DEBs via ≥2 assessments with a time lag of ≥10 years were included. Risk ratios were calculated for baseline to 10-14.9-year (M = 11.04) follow-up and baseline to ≥15-year (M = 18.62) follow-up changes in the use of binge eating, multiple purging, self-induced vomiting, laxatives, diuretics, diet pills, compensatory exercising, fasting/dieting, and multiple DEBs; Cohen's d was used for continuous binge-eating plus purging variable changes. Subgroup and meta-regression analyses tested whether eating disorder (ED) clinical sample versus nonclinical sample status, female versus male sex/gender, higher versus lower study bias, and baseline mean age and body mass index influenced overall effect magnitude for analyses with sufficient data. RESULTS: Seventeen studies (26 [sub]samples) were included. Overall, individuals' risk of engaging in various restrictive eating and other compensatory behaviors decreased over time and the magnitudes of risk reductions for the use of certain compensatory DEBs were larger over longer follow-up durations. Specifically, for significant DEB change models, risk reductions spanned from 20.0-39.8% for 10-year follow-up and 24.7-74.8% for ≥15-year follow-up. However, nuances were found in the nature of these DEB changes as a function of DEB type, follow-up length, ED versus nonclinical sample composition, and baseline mean age. CONCLUSIONS: These findings provide important information that can help identify treatment priorities and suggest that targeted and tailored preventative ED treatments warrant consistent implementation at the community-level, particularly for youth.

OBJETIVO: El presente metaanálisis evaluó los cambios en el riesgo de los individuos de participar en distintas conductas alimentarias anormales (DEBs, por sus siglas en inglés) a largo plazo. MÉTODO: Se incluyeron los estudios longitudinales que evaluaban los cambios en las DEBs a través de evaluaciones ≥2 con un lapso de tiempo de ≥10 años. Se calcularon los cocientes de riesgo para los cambios de seguimiento basales a 10-14.9 años (M = 11.04) y basales a ≥15 años (M = 18.62) en el uso de atracones, purgaciones múltiples, vómitos autoinducidos, laxantes, diuréticos, píldoras de dieta, ejercicio compensatorio, ayuno/dieta y múltiples DEBs; Cohen's d se usó para atracones continuos más cambios variables de purgación. Los análisis de subgrupos y de metarregresión probaron si la muestra clínica del trastorno de la conducta alimentaria (TCA) versus el estado de la muestra no clínica, el sexo/género femenino versus masculino, el sesgo de estudio mayor versus menor, y la edad media basal y el índice de masa corporal influyeron en la magnitud del efecto general para los análisis con datos suficientes. RESULTADOS: Se incluyeron 17 estudios (26 [sub]muestras). En general, el riesgo de las personas de participar en diversas conductas alimentarias restrictivas y otros comportamientos compensatorios disminuyó con el tiempo y las magnitudes de las reducciones de riesgo por el uso de ciertos DEB compensatorios fueron mayores durante períodos de seguimiento más largos. Específicamente, para los modelos de cambio de DEB significativos, las reducciones de riesgo abarcaron desde 20.0-39.8% para 10 años y 24.7-74.8% para seguimientos de ≥15 años. Sin embargo, se encontraron matices en la naturaleza de estos cambios de DEB en función del tipo de DEB, la duración del seguimiento, TCA versus composición de la muestra no clínica y la edad media basal. CONCLUSIONES: Estos hallazgos brindan información importante que puede ayudar a identificar las prioridades de tratamiento y sugieren que los tratamientos preventivos de TCA específicos y personalizados justifican una implementación constante a nivel comunitario, particularmente para los jóvenes.

Racial differences in overeating, loss of control eating, and binge eating: Extending core tenets of the Cognitive Behavioral Theory of Eating Disorders.

PURPOSE: The present study examined racial differences in associations among body dissatisfaction, body checking, and dietary restraint relative to overeating, loss of control eating, and binge eating outcomes among college women. METHOD: Young adult women (N = 903) at three Mid-Atlantic US institutions completed measures assessing negative body image and eating pathology via an online survey. Structural equation modeling was used to test a model examining associations among body dissatisfaction, body checking, dietary restraint, and disinhibited eating behaviors. Multigroup analyses examined whether these associations differed for women who identified as White (n = 432) versus Black (n = 359). RESULTS: More frequent body checking explained associations between elevated body dissatisfaction and more frequent use of all three disinhibited eating outcomes for White and Black women, whereas restraint solely mediated an association between body dissatisfaction and overeating. The assessed constructs generally operated in a similar manner across racial groups. However, stronger associations among body dissatisfaction, restraint, and overeating, and between body checking and loss of control eating were identified for women who identified as White versus Black. CONCLUSIONS: Eating disorder programming efforts targeting body checking behavior may prove useful in decreasing White and Black women's disinhibited eating.

Denial of disordered eating behaviors, suicide, and non-suicidal self-injury in young women.

This study assessed the unique explanatory power of denial of disordered eating in understanding non-suicidal self-injury (NSSI) and suicidality. Undergraduate women (N = 360) completed an online survey about NSSI, suicide risk, disordered eating behaviors, and denial of disordered eating. Denial of disordered eating was associated with NSSI and suicidality above and beyond engagement in disordered eating alone and demographic covariates. This study provided support that denial of disordered eating behaviors assists in understanding risk for NSSI and suicidality. Campus programing might include psychoeducation about the negative consequences of denial and emphasize the importance of disclosure to trusted confidants.

Medication use, sleep, and caregiver smoking status among urban children with asthma.

OBJECTIVE: Children living in urban settings from low-income, minority families are at a high risk for experiencing asthma morbidity. Environmental tobacco smoke (ETS, i.e., secondhand) exposure, typically from caregiver smoking, has been associated with increased quick-relief medication use and child nocturnal awakenings due to increased asthma symptoms as well as worse sleep quality in children with asthma. This study investigated the moderating role of caregiver smoking status on the association between quick-relief medication use and child's sleep quality in urban children with persistent asthma. METHODS: Fifty-four urban children with persistent asthma and their primary caregivers completed a baseline research session. Caregivers then completed ecological momentary assessment surveys via smartphones twice daily for two weeks in which smoking behaviors, child quick-relief medication use, and child's sleep quality were assessed. RESULTS: Twenty caregivers (37%) reported smoking at least one day across the two-week period. The caregiver smoking status significantly moderated the association between quick-relief medication use and child's sleep quality after controlling for child age and monthly household income. The caregiver smoking status exacerbated the association between quick-relief medication use and child's sleep quality, such that more medication usage was associated with worse sleep quality. CONCLUSIONS: Findings suggest that in urban families with a caregiver who smokes, more daily quick-relief medication use may put children at an increased risk for worse sleep quality. The effects of ETS exposure on child's sleep quality in addition to child asthma symptoms should be an integral part of discussions between pediatric healthcare providers and families of children with asthma.