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While boys and men have historically been underrepresented in eating disorder research, increasing interest and research during the twenty-first century have contributed important knowledge to the field. In this article, we review the epidemiology of eating disorders and muscle dysmorphia (the pathological pursuit of muscularity) in boys and men; specific groups of men at increased risk for eating disorders; sociocultural, psychological, and biological vulnerability factors; and male-specific assessment measures. We also provide an overview of current research on eating disorder and muscle dysmorphia prevention efforts, treatment outcomes, and mortality risk in samples of boys and men. Priorities for future research are including boys and men in epidemiological studies to track changes in incidence, identifying (neuro)biological factors contributing to risk, eliminating barriers to treatment access and utilization, and refining male-specific prevention and treatment efforts.

The current study aimed to examine the associations between Minnesota Multiphasic Personality Inventory-3 (MMPI-3) scales and the dimensional personality traits contained within the ICD-11 Personality Disorder diagnosis and DSM-5 Alternative Model for Personality Disorders (AMPD) models. The sample consisted of 489 undergraduate students, with dimensional personality traits operationalized via the Comprehensive Assessment of Traits relevant to Personality Disorder (CAT-PD). A priori hypotheses were generated for which MMPI-3 scales would be most associated with each personality trait domain, as well as individual CAT-PD scales. Zero-order correlations and regression analyses were used to examine associations between a set of hypothesized MMPI-3 scale scores and CAT-PD scale scores. The results showed a pattern of meaningful correlations supporting the majority of hypotheses. Moreover, most hypothesized scales also incremented one another in regression models predicting hypothesized PD scale scores. These findings indicate that the MMPI-3 is well situated to aid clinicians in the assessment of personality trait dysfunction from a dimensional perspective.

Alexithymia is proposed as a prominent clinical feature of eating disorders (EDs). However, despite theoretical reason to believe that alexithymia could interfere with the success of treatments, few studies have tested whether alexithymia changes over the course of treatment. The goals of the current study were to evaluate (a) changes in alexithymia over the course of intensive Dialectical Behaviour Therapy (DBT) for EDs, and (b) associations between alexithymia and ED symptoms over time.A mixed-diagnostic group of patients with EDs (N = 894) completed the Eating Disorders Examination-Questionnaire (EDE-Q) and the Toronto Alexithymia Scale (TAS-20) throughout intensive treatment and at various lengths of follow-up (6, 12, 24 months).Results suggested that even after controlling for relevant covariates, there were significant decreases in alexithymia from intake to discharge and discharge to follow-up. Models exploring changes in self-reported ED symptoms indicated that TAS-20 scores significantly related to ED symptoms across timepoints, such that greater alexithymia was associated with greater severity of symptoms.Altogether, findings support an association between alexithymia and ED symptoms over treatment and suggest that emotion-focussed therapies like DBT may result in decreases in alexithymia. Future research should explore whether this effect is consistent across therapies without an emotional focus.

Sexual minority men (SMM) are disproportionately at risk for suicidality. Furthermore, SMM are at elevated risk for appearance-ideal internalization and body dissatisfaction, which are both associated with suicidality. Theoretical recommendations suggest including interaction terms between appearance-ideal internalization and body dissatisfaction when examining deleterious health outcomes. To test these interactions and examine whether appearance-ideal internalization or body dissatisfaction impart greater suicidality, the current study analyzed associations between specific forms of appearance-ideal internalization and suicidality among SMM, and whether body dissatisfaction moderated these associations. Participants were 171 SMM recruited for an eating disorder prevention program. Analyses examined the association between thin and muscular-ideal internalization with count of suicide risk, with body fat and muscularity dissatisfaction moderating these associations. Zero-inflated Poisson regressions revealed that the association between thin-ideal internalization and suicide risk was moderated by body fat dissatisfaction, such that thin-ideal internalization was associated with increased suicide risk at high levels of body fat dissatisfaction. Muscularity concerns were not significantly associated with suicidality, suggesting that thinness concerns may be more salient than muscularity for suicidality among SMM. Future research should replicate findings among larger SMM samples and extend the current design into non-SMM samples to examine if results generalize to other vulnerable populations.

Investigate the efficacy of a dissonance-based (DB) intervention (i.e., the Body Project), during which some examples of intuitive eating were provided by peer leaders, in improving intuitive eating and targeting risk and protective factors for eating disorders (ED) among Brazilian women with body dissatisfaction. Participants were randomized to a four-session DB intervention (n = 38) or assessment-only control (AOC) (n = 36), and completed validated measures assessing intuitive eating, body appreciation, self-esteem, body-ideal internalization, body dissatisfaction, negative affect, and disordered eating pre-intervention, post-intervention, and at 4- and 24-week follow-ups. The DB condition demonstrated significantly greater increases in intuitive eating, body appreciation and self-esteem scores compared to AOC from pre-intervention to post-intervention (between-condition Cohen's d = 0.73–0.98), 4-week (between-condition Cohen's d = 1.25–1.87) and 24-week follow-up (between-condition Cohen's d = 0.82–1.38). Also, the DB condition showed significantly greater decreases in body-ideal internalization, body dissatisfaction and disordered eating scores from pre-intervention to post-intervention (between-condition Cohen's d = 0.76–1.04), 4-week (between-condition Cohen's d = 1.27–1.71) and 24-week follow-up (between-condition Cohen's d = 1.04–1.19). Regarding negative affect, DB condition showed significantly greater reduction only at 24-week follow-up (between-condition Cohen’s d = 0.60). Results reinforce the efficacy of DB interventions in reducing ED risk factors for young women and support the preliminary efficacy of these programs in improving intuitive eating, body appreciation, and self-esteem. Level I, randomized controlled trial. ReBEC (Brazilian Registry of Clinical Trials; available at http://www.ensaiosclinicos.gov.br/ ) number of registration: RBR-2f57cs. Date of registration: June 1, 2020.

Background Representing the pathological extreme pursuit of muscularity, muscle dysmorphia (MD) is characterized by a pervasive belief or fear around insufficient muscularity and an elevated drive for muscularity. Despite evidence of elevated body image-related concerns among sexual minority populations, little is known about the degree of muscle dysmorphia (MD) symptoms among sexual minorities, particularly based on Muscle Dysmorphic Disorder Inventory (MDDI) scores. The objective of this study was to examine the nature and severity of MD symptoms in cisgender sexual minority men and women and provide community norms of the MDDI for these populations. Methods Data from participants in The PRIDE Study, an existing study of health outcomes in sexual and gender minority people from the United States, were examined. Participants included cisgender gay men (N = 1090), cisgender bisexual plus (bisexual, pansexual, and/or polysexual) men (N = 100), cisgender lesbian women (N = 563), and cisgender bisexual plus women (N = 507). We calculated means, standard deviations (SD), and percentiles for the MDDI total and subscale scores for cisgender sexual minority men and women. We compared MDDI scores by sexual orientation using linear regression models, both unadjusted and adjusted for sociodemographics. Results Overall, the sample was 85.2% White, 3.0% Asian or Pacific Islander, 2.0% Black, 0.5% Native American, 3.9% multiracial, and 6.6% Hispanic/Latino/a. The mean age was 38.6 (SD = 14.3) and 69.4% had a college degree or higher. Means (SD) for the MDDI total score were 27.4 (7.7) for cisgender gay men, 26.4 (6.4) for cisgender bisexual plus men, 24.3 (6.1) for cisgender lesbian women, and 24.6 (5.5) for cisgender bisexual plus women. There were no significant differences in MDDI scores between cisgender gay and bisexual plus men, or between cisgender lesbian women and bisexual plus women in unadjusted or adjusted models. Conclusions These normative data provide insights into the experience of MD symptoms among cisgender sexual minority men and women and can aid researchers and clinicians in the evaluation of MD symptoms and interpretation of MDDI scores in sexual minority populations.

Individuals with anorexia (AN) or bulimia nervosa (BN) often present with fear of loss of control in the context of eating. It is unclear whether this fear of loss of control, which has been associated with fear of failure and a sense of not being in charge of one’s own life in eating disorders, can be distinguished from self-perceived maintained control over food intake in AN. Further, anxious traits are elevated across eating disorders and could contribute to this fear of loss of control. We recruited 113 adult women: restricting type AN (n = 26), BN (n = 28), and healthy controls (CW, n = 59). Participants completed the Eating Expectancies Inventory (EEI), which assesses learned expectations on the effects of eating, including whether Eating Leads to Feeling out of Control, and the Trait Food Craving Questionnaire (FCQ-T), which measures food craving and the ability to withstand those cravings, including self-perceived Lack of Control Over Eating. Eating Leads to Feeling out of Control was elevated in AN and BN compared to CW. Lack of Control Over Eating was similar between AN and CW but elevated in BN. Intolerance of uncertainty correlated with those measures in CW only. Individuals with restricting-type AN experience feeling out of control when eating while maintaining self-perceived control over eating. The EEI’s eating leads to feeling out of control is associated with negative self-improvement expectations. Targeting self-improvement through more functional strategies could be an important aspect in psychotherapy in AN and reduce the perceived need to restrict food intake. Level III, Evidence obtained from well-designed cohort or case–control analytic studies.

Emotional processes play a role in both suicide risk and eating disorders (EDs), which are often comorbid. However, limited research has explored how emotional processes relate to suicide risk in EDs and the prognostic value of suicide risk for ED treatment. Thus, the current study examined associations between emotion dysregulation and reactivity with suicide risk in patients with EDs, and determined if suicide risk predicts ED treatment outcomes.Participants (n = 201) were adults in an ED partial hospitalization program who completed measures at admission, 1-month post-admission, and discharge.When controlling for depressive symptoms, limited access to adaptive emotion regulation strategies, difficulties engaging in goal-oriented behaviors, and engaging in impulsive behavior when experiencing negative emotions (i.e., emotion dysregulation) were associated with suicide attempt frequency. Depressive symptoms were associated with suicide risk severity, while emotion dysregulation and reactivity were not. Importantly, patients with elevated suicide risk at admission improved comparably to other risk categories across treatment, despite presenting with greater ED symptoms at admission.Emotion dysregulation and depression are salient factors when examining suicide risk in patients with EDs. Suicide risk and attempt history may not negatively impact ED treatment outcomes when using emotion-focused treatment.

The recently released Minnesota Multiphasic Personality Inventory-3 (MMPI-3) includes a revised set of Validity Scales on which there is currently limited validity and clinical utility evidence for the detection of overreporting. The present study evaluated the MMPI-3 Validity Scales in the identification of such response bias. An analogue simulation design was used in which participants in an overreporting condition (163 undergraduate students) were instructed to feign mental health symptoms when responding to the MMPI-3 in the context of a compensation-seeking claim. Two comparison groups (657 undergraduate students and 223 community mental health patients) were instructed to respond to the MMPI-3 under standard instructions. The results indicated that those in the overreporting group generally had higher scores on MMPI-3 substantive scales than did genuine responding patients and students. In addition, results indicated that the criterion validity of the substantive scale scores was compromised in the context of overreporting. All MMPI-3 Validity Scales, particularly Fp (

Eating disorders (EDs) are more common among younger women compared to older women and in women compared to men. As such, most ED research focuses on late adolescent and young adult females resulting in limited prospective research on gender differences in eating disorder psychopathology across the life span. The present study addresses this gap by examining gender differences in ED diagnoses, eating pathology, and the impact of putative risk factors on eating pathology in women (n = 624) and men (n = 276) over a 30-year period from late adolescence (M (SD) = 20[2] years) to later midlife (M (SD) = 50[2] years). Four assessment waves were conducted, beginning with baseline participation during college and subsequent 10-, 20-, and 30-year follow-up. Retention at 30-year follow-up was 72% (n = 440) for women and 67% (n = 181) for men. Prevalence of DSM-5 ED diagnoses decreased over the 30-year span for women and remained stable for men, with no significant gender difference in point prevalence by age 50. Drive for thinness decreased for women through age 50 and increased for men, while bulimic symptoms decreased as both genders aged. Multilevel models demonstrated that the impact of dieting as a risk factor on drive for thinness decreased prospectively as men aged and remained stable as women aged. Results imply that current risk models require refinement to account for developmental trajectories in which dramatic gender differences observed in late adolescence diminish over time. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Over the past several decades, Dialectical Behavior Therapy (DBT) has been adapted for a range of presenting problems related to emotion dysregulation. Considerable enthusiasm exists regarding the use of DBT for treating eating disorders; however, to date, there have been no reviews summarizing empirical efforts to adapt DBT for eating disorders in youth. Accordingly, in the present narrative review, we provide a comprehensive summary of existing work testing DBT for adolescent eating disorders. First, we briefly review existing work applying DBT to eating disorders in adults and general adolescent samples. We then review research focused specifically on the use of DBT for adolescent eating disorders, including both those studies applying DBT as the primary treatment and investigations of DBT as an adjunctive treatment. Overall, initial results for DBT-based approaches are promising. However, rigorous empirical work testing DBT for treating adolescent eating disorders remains limited; the majority of existing research is comprised of case series and small-scale studies. Therefore, we close with specific recommendations for future research testing this approach.

Dialectical behavior therapy (DBT) has theoretical and clinical relevance, as well as burgeoning empirical support, for the treatment of eating disorders (ED). Originally developed for patients wit...

The purpose of the current study was to extend research on the Personality Disorder (PD) Spectra scales developed for the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF). We evaluated the scales against measures of both the DSM-5 Section II (traditional model) and Section III (Alternative Model of Personality Disorders; AMPD) PD diagnostic criteria. The participants were 474 undergraduate students from the University of Otago who were administered a range of measures for both DSM-5 PD models. The MMPI-2-RF PD Spectra scales showed significant moderate to large correlations with traditional PD measures, with the exception of Histrionic PD, as well as evidenced incremental validity over the MMPI-2-RF Personality Psychopathology-5 (PSY-5) – the only current formal measurement of personality pathology on the MMPI-2-RF- in accounting for scores on traditional PD measures. The MMPI-2-RF PD Spectra scales also showed moderate to high correlations with most hypothesized AMPD personality trait and impairment scales used to assess DSM-5 AMPD diagnostic criteria. The findings indicated that the scales align well with both paradigms for PD assessment, situating the MMPI-2-RF in a unique position as a bridging measure.

Despite initial data suggesting positive treatment outcomes for adolescent eating disorder day-hospital programmes (DHPs), existing studies have included limited follow-up, small samples, and a focus on restricting-type eating disorders. To address these gaps, we explored naturalistic outcomes for an adolescent eating disorders DHP. Adolescent participants (N = 265) completed measurements at treatment admission, discharge (n = 170), and various lengths of follow-up (n = 126; Mfollow up = 278.87 days). Results from multilevel models indicated significant increases in body weight for the anorexia nervosa group throughout treatment and maintenance of increased body weight from discharge to follow-up. In bulimic spectrum disorders, binge eating and purging significantly decreased from intake to discharge and did not change from discharge to follow-up. Across the entire sample, eating disorder symptoms decreased from intake to discharge and did not change from discharge to follow-up. Further, anxiety and depression decreased over the course of treatment and continued to decrease over the follow-up period. The current investigation represents the first study to explore longitudinal DHP outcomes within adolescent bulimic spectrum eating disorders. Our findings also highlight many challenges inherent in conducting naturalistic research; it is critical that the field continue to develop solutions to the barriers inherent in conducting longitudinal research on eating disorder treatment.

Missing or inconsistent responses on self-report assessments can have implications for the use of empirically validated measurements in research and clinical practice. However, literature on frequency and systematic patterns of missingness on common measures of eating pathology is lacking. The current study evaluated EDE-Q missing and inconsistent responding in a clinical eating disorders (EDs) sample (N = 739). Thirteen percent (13.4%; n = 99) of the sample failed to provide complete responses on the EDE-Q and 13.8% (n = 101) inconsistently responded to behavioral items of the EDE-Q. Males were more likely to provide missing data, and mean BMI was higher among individuals with missing responses. Inconsistent responders endorsed higher scores on several EDE-Q subscales, were younger, and were more likely to be Hispanic/Latinx. However, many of these differences were not significant following correction for multiple comparisons. Although our results indicated similar rates of missingness and inconsistency to past work in college samples, our results suggest that missing and inconsistent responding on the EDE-Q in clinical samples may not warrant specialized consideration within statistical analyses.

Despite increasing empirical interest in muscle dysmorphia (MD), a dearth of research has assessed this construct in sexual minority populations. In particular, the psychometric properties of one of the most widely used measures of MD symptoms-the Muscle Dysmorphic Disorder Inventory (MDDI)-have not been evaluated in sexual minority populations despite emerging evidence suggesting differential risk for MD symptoms across sexual orientation groups. In this study, we assessed the psychometric properties of the MDDI in a sample of 715 cisgender gay men and 404 cisgender lesbian women ages 18-50 years who participated in a large-scale national longitudinal cohort study of sexual and gender minority adults. The factor structure of the MDDI was examined in each sample using a two-step, split-sample exploratory and confirmatory factor analytic approach. Exploratory factor analysis supported a three-factor structure in both samples, which were confirmed by confirmatory factor analysis. Moreover, results supported the internal consistency reliability and convergent validity of the MDDI subscales in both samples. Cumulatively, these findings suggest that the MDDI is an appropriate measure of MD symptoms among cisgender gay men and cisgender lesbian women.

Purpose Representing the pathological extreme pursuit of muscularity, muscle dysmorphia (MD) is characterized by a pervasive belief or fear around insufficient muscularity and an elevated drive for muscularity. Despite evidence of heightened body image-related concerns among gender minority populations, little is known about the degree of MD symptoms among gender minorities, particularly based on Muscle Dysmorphic Disorder Inventory (MDDI) scores. The objective of this study was to assess community norms of the MDDI in gender-expansive people, transgender men, and transgender women. Method Data from participants in The PRIDE Study, an existing study of health outcomes in sexual and gender minority people, were examined. We calculated means, standard deviations, and percentiles for the MDDI total and subscale scores among gender-expansive people (i.e., those who identify outside of the binary system of man or woman; n = 1023), transgender men (n = 326), and transgender women (n = 177). The Kruskal-Wallis test was used to assess group differences and post hoc Dunn’s tests were used to examine pairwise differences. Results Transgender men reported the highest mean MDDI total score (30.5 ± 7.5), followed by gender-expansive people (27.2 ± 6.7), then transgender women (24.6 ± 5.7). The differences in total MDDI score were driven largely by the Drive for Size subscale and, to a lesser extent, the Functional Impairment subscale. There were no significant differences in the Appearance Intolerance subscale among the three groups. Conclusions Transgender men reported higher Drive for Size, Functional Impairment, and Total MDDI scores compared to gender-expansive people and transgender women. These norms provide insights into the experience of MD symptoms among gender minorities and can aid researchers and clinicians in the interpretation of MDDI scores among gender minority populations., Plain English summary Transgender people have a gender identity or expression that differs from what is typically associated with the sex assigned to them at birth. Gender-expansive refers to gender identities that do not fit within the binary (woman/man) gender system. We asked gender-expansive people, transgender men, and transgender women in The PRIDE Study to fill out a widely used survey about muscle dysmorphia, a condition in which a person worries they are not muscular enough. The results showed that transgender men had the highest muscle dysmorphia symptoms, followed by gender-expansive people, then transgender women. These findings can help clinicians and researchers in interpreting a survey assessing muscle dysmorphia in gender-expansive people, transgender men, and transgender women. Characterizing muscle dysmorphia symptoms in these populations is an important step to improve mental wellness among transgender and gender-expansive people.

Objective The current study examined associations between Minnesota Multiphasic Personality Inventory-3 (MMPI-3) scales and self-reported DSM-5 Section II personality disorder (PD) symptoms. A priori hypotheses were generated for which MMPI-3 scales would be most highly associated with each PD. Methods We used a large sample (n = 489) of university students, who completed the MMPI-3 and two established self-report measures of personality disorders. Results The results were generally consistent with theoretical expectations and previous research utilizing the MMPI-2-RF. Specifically, most hypothesized MMPI-3 scales exhibited meaningful associations with relevant PD variables, although there were some notable exceptions. The regression models revealed significant predictors for each PD which were generally consistent with expectations and previous research. Conclusions Overall, the MMPI-3 appears well situated to cover a range of DSM-5 Section II PD-related psychopathology, and three of the new MMPI-3 scales appear to have added utility for assessing personality pathology.

Background Adult eating disorder treatments are hampered by lack of access and limited efficacy. This open-trial study evaluated the acceptability and preliminary efficacy of a novel intervention for adults with eating disorders delivered to young adults and parent-supports in an intensive, multi-family format (Young Adult Temperament-Based Treatment with Supports; YA-TBT-S). Methods 38 YA-TBT-S participants (m age = 19.58; SD 2.13) with anorexia nervosa (AN)-spectrum disorders, bulimia nervosa (BN)-spectrum disorders, and avoidant/restrictive food intake disorder (ARFID) completed self-report assessments at admission, discharge, and 12-month follow-up. Assessments measured program satisfaction, eating disorder psychopathology and impairment, body mass index (BMI), and trait anxiety. Outcomes were analyzed using linear mixed effects models to examine changes in outcome variables over time. Results Treatment was rated as highly satisfactory. 53.33% were in partial or full remission at 12-month follow-up. 56% of participants received other treatment within the 12-month follow-up period, suggesting that YA-TBT-S may be an adjunctive treatment. Participants reported reductions in ED symptomatology (AN and BN), increases in BMI (AN and ARFID), and reductions in clinical impairment (AN and ARFID) at 12-month follow-up. Conclusions YA-TBT-S is a feasible and acceptable adjunctive treatment for young adults with a broad range of ED diagnoses and may be a method for involving parents in ED treatment in ways that are acceptable to both parents and YA. Further evaluation of efficacy is needed in larger samples, and to compare YA-TBT-S to other ED treatment approaches. Plain English summary Eating disorders are costly and dangerous psychiatric disorders that affect millions of individuals each year. Despite their risks and societal costs, currently available treatments are limited. This study examined the acceptability and efficacy of Young Adult, Temperament-Based Treatment with Supports (YA-TBT-S), a new treatment program for adults with eating disorders. YA-TBT-S was rated highly, and a significant portion of participants improved based on ratings collected 12 months after program participation. Those with anorexia nervosa (AN) and bulimia nervosa (BN) showed significant reductions in eating disorder pathology, and those with AN and avoidant/restrictive food intake disorder (ARFID) showed increases in BMI over time.

OBJECTIVE Body dissatisfaction is intricately linked to the development of disordered eating. However, as male body dissatisfaction appears more oriented toward muscularity, versus thinness per se, existing measures of eating disorder psychopathology may lack sensitivity in capturing disordered eating that is muscularity-focused. The aim of the present study was to develop a specific measure of muscularity-oriented disordered eating-the muscularity-oriented eating test (MOET). METHOD Candidate items were generated and refined in consultation with eating disorder-focused researchers and focus groups of men with eating disorders. Examination of the MOET comprised two studies, consisting of 511 undergraduate men, divided into two component samples. In Study 1 (n = 307), candidate items were generated and refined via exploratory factor analysis (EFA). Confirmatory factor analysis (CFA) was then used to confirm the single factor structure in Study 2 (n = 204). RESULTS EFA revealed a 15-item single factor structure, which was later confirmed through CFA in a separate sample of undergraduate men. Furthermore, the MOET yielded evidence of internal consistency (Study 1: omega = 0.93, 95% CI [0.91, 0.94]; Study 2: omega = 0.92, 95% CI [0.90, 0.93]), 7-day (Study 1) and 21-days (Study 2) test-retest correlation (rs = .75, for Study 1 and 2) and convergent and divergent validity. DISCUSSION The MOET represents a psychometrically sound, novel measure of muscularity-oriented disordered eating. Future research should examine its utility in clinical samples and research into muscularity-oriented disordered eating.

Child abuse and neglect is a perplexing public health, human rights, and social justice issue that persists at unacceptable levels. This qualitative survey, involving brief oral conversations ( n = 721) about perceptions of child abuse and neglect and its solutions, was drawn from a randomized telephone survey of residents in two U.S. communities. The study focused on two research questions: (a) individual and collective actions that would give child abuse and neglect prevention the best chance for success and (b) what participants would expect to see in a local child abuse prevention effort to have faith in its effectiveness. Participants were mostly female (61%), with the average age of 55.7 years, and had a median income of US$35,000 to US$49,000. Thirty-one percent identified as mandatory reporters and 76% were a primary caregiver for a child at some point in their lives. Thematic analysis identified six themes and one subtheme for the first research question and four themes for the second research question. Participants emphasized the importance of awareness raising, education, broad public support and the value of a locally developed plan, credible leadership, and reliable follow-through. Participants’ beliefs and recommendations were mapped to existing and promising child abuse prevention frameworks and implications for prevention planning are outlined.

Dialectical behavior therapy (DBT) has demonstrated initial efficacy for the treatment of eating disorders (EDs). However, no study has examined potential processes that may contribute to observed improvements in DBT for EDs. The present study sought to investigate changes in DBT skills use throughout treatment as a predictor of symptom change in a DBT-based partial hospital program (PHP) for adults with EDs. Adults [n = 135; M(SD) age = 25.08 (7.88)] with EDs completed self-report measures at treatment admission, one-month post-admission, and discharge from PHP. DBT skills use, as measured by the DBT Ways of Coping Checklist, increased by 12.65% from admission to one-month post-admission and increased by 24.10% from admission to discharge. Early (admission to month 1) and later (month 1 to discharge) improvements in DBT skills use predicted greater improvements in ED, depressive, and emotion dysregulation symptoms from treatment admission to discharge. Notably, early versus later change in skills use was a stronger predictor of outcome. Results are consistent with the theoretical model of DBT and add to a growing literature on DBT for EDs.

This study examined the validity of the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF; Tellegen & Ben-Porath, 2011) Uncommon Virtues (L-r) and Adjustment Validity (K-r) scales in detecting underreporting. The study aimed to increment the previous literature in this field using a New Zealand population. We used a combined sample of 784 university students, with 173 participants completing the MMPI-2-RF with instruction to underreport in the context of applying for a job, and 611 completing the test under standard instructions. Results indicated that individuals who completed the MMPI-2-RF with underreporting instructions exhibited significantly lower scores on the majority of the MMPI-2-RF substantive scales, and significantly higher scores on the L-r and K-r validity scales. Additionally, L-r and K-r added incremental predictive utility over one another when differentiating the standard instruction and underreporting groups. Classification accuracy analyses provided additional evidence for the utility of the L-r and K-r scales by supporting their respective cut scores listed in the MMPI-2-RF manual (Ben-Porath & Tellegen, 2011). The findings of this study provide further evidence for the utility of the L-r and K-r scales in detecting underreporting extension to both a preemployment evaluation context and a novel population.

The purpose of the current study was to evaluate the validity of scores on the Eating Concerns (EAT) scale on the recently released Minnesota Multiphasic Personality Inventory-3 (MMPI-3), which aims to assess for problematic eating behaviours. It was hypothesised that the EAT scale scores would be correlated with binge eating, purging, restrictive eating, weight and body shape concerns. Participants were 396 university students, who completed a series of well-validated eating disorder measures. The EAT scale scores evidenced moderate to large correlations with many symptom dimensions of EDs, including binge eating, purging, restrictive eating and weight and shape concern, thus, supporting the hypotheses and showing evidence for criterion validity. Hierarchical regression analyses also revealed incremental validity for the EAT scale above and beyond other MMPI-3 Specific Problems scale scores. Overall, scores on the new MMPI-3 EAT scale were associated with positive support for validity in a university population and seem promising as a good screening measure for eating pathology.

Anxiety and eating disorders (EDs) often co-occur, prompting calls to explore anxiety-related maintenance processes in ED samples. Safety behaviors, which function to prevent a feared outcome from occurring or to reduce anxiety associated with a feared stimulus, are observed across anxiety disorders and, along with overt avoidance behaviors, are an important target in treatment. Data suggest that individuals with EDs also engage in safety behaviors. However, no existing assessments provide a comprehensive measure of eating-disorder-specific overt avoidance and safety behaviors. The goal of this Stage 1 Registered Report is to develop a comprehensive self-report measure of ED-specific safety behaviors. In Study 1, we will recruit 50 women with EDs to complete the scale and provide feedback on the response scale. Feedback from these participants will be used to refine the measure. In Study 2, we will evaluate the psychometric properties of the measure in a large sample of women with EDs (n dependent on the size of measurement) and a community sample without current or a history of ED symptoms. We will explore the measure factor structure, known-groups validity by comparing scores from women with EDs to healthy controls, internal consistency, and convergent and divergent validity with other psychological instruments.

PURPOSE OF REVIEW: In current review, we evaluate the current literature examining the role of disgust in eating disorders (EDs), and provide a theoretical model designed to inform the study and treatment of disgust-based symptoms in EDs. RECENT FINDINGS: Findings from this review suggest that aberrant disgust-conditioning processes represent promising but understudied mechanisms that may contribute to the risk and maintenance of core eating disorder (ED) psychopathology. In addition, preliminary evidence supports the use of interventions designed to target aversive disgust cues and disrupt maladaptive disgust-based conditioning that may maintain eating pathology. However, experimental studies designed to elucidate the role of disgust and aversive learning processes remain limited. SUMMARY: Disgust is a promising risk and maintenance factor in EDs. Future systematic investigation is needed to examine disgust-based processes at a mechanistic level in order to better understand the links between disgust, avoidance behaviors, and EDs. Further investigation of the mechanistic role of disgust in EDs is warranted.

In this book, we summarize the most up-to-date information on eating disorders among boys and men regarding presentation, assessment, medical and nutritional considerations, prevention, treatment, and sociocultural considerations. These chapters also identify key gaps and areas of future research to further drive the field. More sensitive methods to screen for eating disorders and to differentiate drive for muscularity from eating disorder pathology in boys and men are needed. In addition, there is a need for more research to better understand the extent to which existing eating disorder diagnostic frameworks and criteria adequately capture the full spectrum of symptoms in boys and men. Additional research in clinical samples is particularly essential to inform medical standards and guidelines for eating disorders in boys and men focused on monitoring bone health, testosterone testing, determining goal weights in treatment, and protocols for refeeding. Randomized controlled trials for prevention and treatment of eating disorders in boys and men are required. Finally, research in diverse samples across races, ethnicities, ages, sexual orientations, gender identities, nationalities, socioeconomic strata, and body sizes are needed.

While research on eating disorder (ED) prevention has traditionally focused on female populations, growing recognition that eating and appearance-based disorders do occur in boys and men has led to an increase in body image interventions and eating disorder prevention programs for boys and men. Research to date has tested prevention programs delivered as early as elementary school through young adulthood, using in-person and Internet-based delivery modalities. In this chapter, we review programs that have included boys and men in (1) school-based prevention programs, (2) in-person prevention programs, (3) Internet-based prevention programs, and (4) dual prevention programs targeting weight and EDs. Although many programs have helped reduce risk factors for EDs, such as body dissatisfaction, only a few programs have demonstrated the ability or potential to prevent ED symptoms and, particularly, ED onset. Across studies, the lack of measurement of male-specific constructs (e.g., muscularity) and the tendency for mixed-gender programs to lack content relevant to boys and men highlight the need to design male-specific programs with appropriate assessment measures. We end the chapter with future directions for the field of eating disorder prevention in populations of boys and men.

Although much of the literature on eating disorders and body dissatisfaction among men involves samples in early adulthood, these concerns can affect boys and men across the lifespan. Evidence suggests that socioculturally prescribed body size preferences and body dissatisfaction can emerge even in early childhood, as can eating disturbances of various forms (e.g., loss of control eating, restrictive eating). Adolescence represents a developmental period of elevated risk for the onset and/or exacerbation of body dissatisfaction and eating disorder symptoms. Importantly, given the lean and muscular nature of the sociocultural body ideal for boys and men, maladaptive body- and eating-related attitudes and behaviors may be influenced by pursuit of low body fat/weight loss, increased muscularity/weight gain, or some combination of both. Further, a small but growing body of literature supports that body image and eating concerns continue for men in midlife and beyond. Unique body image concerns in this group may include (perceived) loss of body functionality, loss of muscularity and masculinity, and age-related weight gain. Dieting behaviors and drive for thinness may increase into midlife for men, and andropause may be related to greater levels of disordered eating. While gender differences in disordered eating and eating disorders in adolescence and young adulthood have been well-established, recent research suggests that these gender differences may diminish in midlife. This chapter provides an overview of the nature and prevalence of body dissatisfaction, disordered eating, and eating disorders in boys and older men while also addressing salient developmental considerations across the lifespan.

OBJECTIVE Individuals with eating disorders (EDs) often have difficulty tolerating uncomfortable body sensations. As such, anxiety sensitivity specific to gastrointestinal (GI) sensations, has relevance for EDs. However, to date, no validated measures of this construct exist in EDs. Thus, the present study sought to validate the visceral sensitivity index (VSI), a 15-item measure originally validated in an irritable bowel syndrome sample, in an ED sample and explore associations with ED symptoms. METHOD Two hundred and sixty-six adolescents (n = 116) and adults (n = 150) in an ED partial hospital program completed the VSI and related measures at admission. Confirmatory factor analysis examined the factor structure of the VSI and hierarchical regression analyses explored associations between the VSI and ED symptoms. RESULTS The original version of the VSI had adequate model fit. An alternative 13-item model removing specific items with poor fit and less theoretical relevance to EDs also demonstrated good fit. The 15-item and 13-item VSI had strong internal consistency (α = .93-.94), and correlation results supported the convergent and divergent validity of both versions. Higher visceral sensitivity was associated with elevated body dissatisfaction, cognitive restraint, purging, restricting, and excessive exercise (p-values

The utility of traditional eating disorder measures in the assessment of muscularity-oriented disordered eating has been questioned. To address this limitation, the Muscularity-Oriented Eating Test (MOET) was recently developed and validated in a sample of U.S. college men. We aimed to develop a multicultural Spanish-language version of the MOET for use in Latin American samples and validate its use in a sample of Argentinian college men. Combined translation procedures were used to develop a version suitable for different Spanish-speaking populations. A total of 235 students (Mage = 23.47, SD = 5.61) participated in this study by completing a survey including the MOET. A sub-sample (n = 121) completed the MOET again after 1 week. A confirmatory factor analysis of a re-specified model of the original single-factor MOET, allowing for residual correlation between items associated to dietary rules (items 4-12), resulted in an adequate fit (χ2/df = 2.10, CFI = 0.94, TLI = 0.93, RMSEA 0.05 [90% CI = 0.04, 0.06] SRMR = 0.08). Further, the multicultural Spanish-language version of the MOET yielded evidence of internal consistency (omega = 0.83, 95% CI [0.79, 0.88], Cronbach's α = 0.83), a 1-week Intraclass Correlation Coefficient was considered for test-retest reliability (ICC = 0.82), item analysis, convergent validity with measures of eating disorder psychopathology, body dissatisfaction and weight-related behaviors, as well as for divergent validity with an unrelated construct. The availability of a multicultural Spanish-language version of the MOET may have utility in both clinical and research efforts related to muscularity-oriented disordered eating among Latino men.

Eating disorders affect individuals across all demographic strata and indicators of social location, including sex, age, weight, ability, socioeconomic position, race, and ethnicity. Sexual and gender minority populations are diverse subgroups who have been identified as exhibiting elevated prevalence of eating disorders and disordered weight and shape concerns. The goals of this chapter are threefold: (1) to review the state of the research on eating disorders and eating disorders treatment and prevention among sexual and gender minorities, including relevant theory and epidemiology on health inequities; (2) to discuss the state of evidence-based treatment and, by necessity, discuss critical gaps in research and clinical practice that have impeded the development of tailored and targeted eating disorder treatment and prevention for sexual and gender minority populations; and (3) to describe recommendations for future research and clinical practice. Given the paucity of formal evidence evaluating the efficacy of evidence-based treatment for sexual and gender minority populations, we issue 12 concrete recommendations derived from epidemiologic research and perspectives from providers and individuals with lived experience to help prioritize research efforts and guide the future development and implementation of evidence-based treatment of eating disorders for sexual and gender minority individuals.

Eating disorders (EDs) and anxiety disorders (ADs) evidence shared risk and significant comorbidity. Recent advances in understanding of anxiety-based disorders may have direct application to research and treatment efforts for EDs. The current review presents an up-to-date, behavioral conceptualization of the overlap between anxiety-based disorders and EDs. We identify ways in which anxiety presents in EDs, consider differences between EDs and ADs relevant to treatment adaptions, discuss how exposure-based strategies may be adapted for use in ED treatment, and outline directions for future mechanistic, translational, and clinical ED research from this perspective. Important research directions include: simultaneous examination of the extent to which EDs are characterized by aberrant avoidance-, reward-, and/or habit-based neurobiological and behavioral processes; improvement in understanding of how nutritional status interacts with neurobiological characteristics of EDs; incorporation of a growing knowledge of biobehavioral signatures in ED treatment planning; development of more comprehensive exposure-based treatment approaches for EDs; testing whether certain exposure interventions for AD are appropriate for EDs; and improvement in clinician self-efficacy and ability to use exposure therapy for EDs.

Aim: No measure has formally been developed to assess the published ICD-11 model of Personality Disorder (PD) severity. We therefore set out to develop and evaluate the 14-item Personality Disorder Severity ICD-11 (PDS-ICD-11) scale. Method: A representative U.S. community sample (N = 428; 50.9% women) and a New Zealand mental health sample (N = 87; 61.5% women) completed the PDS-ICD-11 scale along with a series of established PD and impairment measures. Results: Item response theory supported the unidimensionality of PDS-ICD-11 (median item loading of 0.68) and indicated that a PDS-ICD-11 score of 17.5 may serve as a benchmark for pronounced dysfunction. Correlation and regression analyses supported both criterion validity and incremental validity in predicting impairment and PD symptoms. The PDS-ICD-11 was particularly associated with measures of Level of Personality Functioning Scale (LPFS), Global PD severity, and Borderline PD symptom score. A comparison between clinical individuals diagnosed with an ICD-11 PD vs. no PD supported diagnostic validity. Conclusion: This initial construction study suggests that the PDS-ICD-11 constitutes a promising instrument that provides a quick impression of the severity of personality dysfunction according to the official ICD-11 PD guidelines. Clearly, more research is needed to corroborate its validity and utility. The PDS-ICD-11 scale is provided as online supporting information.

Author(s): Brown, Tiffany A; Murray, Stuart B; Anderson, Leslie K; Kaye, Walter H | Abstract: ObjectivePrevious research supports the relevance of early symptom change in eating disorder (ED) treatment; however, few studies have distinguished early weight change from early change in ED psychopathology, particularly in higher levels of care. Thus, the present study examined whether early change in weight and ED psychopathology predicted outcome for adolescents with anorexia nervosa (AN) in a partial hospitalization program.MethodAdolescents with AN (n = 99) completed assessments at admission, 1-month after treatment admission, discharge, and 6-month follow-up.ResultsHigher admission percent expected body weight (%EBW), greater early change in %EBW, longer duration of treatment, shorter length of illness, and earlier age of onset predicted greater change in %EBW at discharge, but not follow-up. Greater ED psychopathology at admission and greater early change in ED psychopathology predicted later change in ED symptoms at discharge, but not follow-up. Neither early change in %EBW nor ED psychopathology predicted likelihood of remission at discharge and follow-up.DiscussionResults support the importance of early change in predicting later change in the same ED outcome variables and suggest that early change in both %EBW and ED psychopathology in adolescents may be an important area for future research.

Previous research has demonstrated that both suicidal ideation (SI) and eating disorders (EDs) are associated with poor interoceptive awareness (IA). Suicidality research has demonstrated that the IA dimension of lower body trust is associated with SI, suicide plans, and suicide attempts. Similarly, in ED samples, recent research supports that low body trust has been the most robust dimension of IA associated with eating pathology. However, to date, research is lacking in how dimensions of IA may be associated with SI in an ED sample, above and beyond the impact of eating pathology on SI. Thus, in a clinical ED sample, the present study sought to determine which IA dimensions predict the presence and severity of SI, above and beyond ED symptoms. Participants (N = 102) completed a clinical interview assessing SI and self-report assessments including the Multidimensional Assessment of Interoceptive Awareness (MAIA). Results demonstrated that patients with current SI reported greater ED psychopathology, lower MAIA Attention Regulation, MAIA Self-Regulation, and MAIA Trusting scores compared to patients without SI. Higher ED psychopathology and lower MAIA Attention Regulation, Self-Regulation, and Trusting subscale scores were all significantly associated with the presence of SI. However, only low MAIA Trusting scores predicted the presence of SI, above and beyond covariates (age, depression, and eating pathology). No MAIA subscales were correlated with the severity of SI. Consistent with previous research, results suggest low MAIA Trusting scores may be associated with SI in ED samples and highlight the need for future research on mechanisms of these associations.

Research supports increasing cultural pressures for leanness among young men; however, few studies have examined whether weight dissatisfaction or efforts to alter weight have become more prevalent for men over time. The present study evaluated secular trends in weight dissatisfaction and related behaviors among college-age men across 4 decades; 1,097 men completed surveys while they were in college in 1982 (n = 276), 1992, (n = 233), 2002 (n = 241), and 2012 (n = 347). In 1982, men with a body mass index (BMI) between 18.5 and 25 kg/m2 were more likely to describe themselves as being overweight compared with men in all other cohorts, whereas in 1992, 2002, and 2012, men with a BMI between 18.5 and 25 kg/m2 were more likely to describe themselves as underweight compared with men in all other cohorts. Overall, 57-62% of men reported weight dissatisfaction, although there were no significant differences in the proportion of men wanting to lose, maintain, or gain weight across cohorts. There was no significant difference in the amount of weight gain desired across cohorts despite increasing BMI from 1982 to subsequent cohorts; however, desired BMI and endorsement of fad diets differed across cohorts, with higher desired BMI in 1992 and 2002 and high-protein diets being the most common in 2012. These results suggest that weight dissatisfaction has remained substantial and relatively stable among young men over time. Trends relating to weight perception, dieting, and exercise are consistent with an increasing focus on leanness and muscularity for men in recent years. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Author(s): Donahue, Joseph M; DeBenedetto, Anthony M; Wierenga, Christina E; Kaye, Walter H; Brown, Tiffany A | Abstract: ObjectiveEpidemiological data support that sexual minorities (SM) report higher levels of eating pathology. Theories suggest these disparities exist due to stressors specific to belonging to a minority group; however, few studies have specifically explored differences between SM and heterosexual individuals in clinical eating disorder samples. Thus, the present study compared SM and heterosexual patients with eating disorders on demographic characteristics and eating disorder and psychological outcomes during day hospital treatment.MethodPatients (N = 389) completed surveys of eating pathology, mood, anxiety, and skills use at treatment admission, 1-month post-admission, discharge, and 6-month follow-up. Overall, 19.8% of patients (n = 79) identified as SM, while 8.0% (n = 32) reported not identifying with any sexual orientation. SM were more likely to present across genders (17.7% of females, 24.2% of males, 33.3% of transgender patients, and 87.5% of nonbinary patients).ResultsSM patients were significantly more likely to endorse major depressive disorder, panic disorder, and self-harm at admission than their heterosexual counterparts. Multilevel models demonstrated that across time, SM patients demonstrated greater eating pathology, emotion dysregulation, depressive symptoms, and anxiety symptoms. Significant interactions between sexual orientation and time were found for eating pathology and emotion dysregulation, such that although SM patients started treatment with higher scores, they improved at a faster rate compared to heterosexual patients.DiscussionConsistent with minority stress theory, SM patients report greater overall eating disorder and comorbid symptoms. Importantly, results do not support that there appear to be significant disparities in treatment outcome for SM patients in this sample of day hospital patients.

Emotion regulation deficits are associated with eating disorder (ED) symptoms, regardless of eating disorder diagnosis. Thus, recent treatment approaches for EDs, such as dialectical behavior therapy (DBT), have focused on teaching patients skills to better regulate emotions. The present study examined changes in emotion regulation among adult patients with EDs during DBT-oriented partial hospital treatment, and at follow-up (M[SD] = 309.58[144.59] days from discharge). Exploratory analyses examined associations between changes in emotion regulation and ED symptoms. Patients with anorexia nervosa, restricting (AN-R, n = 77), and binge-eating/purging subtype (AN-BP, n = 46), or bulimia nervosa (BN, n = 118) completed the Difficulties in Emotion Regulation Scale (DERS) at admission, discharge, and follow-up. Patients with BN demonstrated significant improvements across all facets of emotion dysregulation from admission to discharge and maintained improvements at follow-up. Although patients with AN-BP demonstrated statistically significant improvements on overall emotion regulation, impulsivity, and acceptance, awareness, and clarity of emotions, from admission to discharge, these improvements were not significant at follow-up. Patients with AN-R demonstrated statistically significant improvements on overall emotion dysregulation from treatment admission to discharge. Changes in emotion regulation were moderately correlated with changes in ED symptoms over time. Results support different trajectories of emotion regulation symptom change in DBT-oriented partial hospital treatment across ED diagnoses, with patients with BN demonstrating the most consistent significant improvements.

There is a critical need to identify processes that may influence outcome in existing treatments for eating disorders (EDs). Intolerance of uncertainty (IU), which refers to excessive distress regarding uncertain situations, is a well-established feature of anxiety disorders. Emerging work suggests that IU decreases over the course of cognitive-behavioral treatments and may relate to better treatment outcomes. As some literature has suggested IU may functionally maintain ED symptoms, testing whether changes in IU over treatment relate to outcome may result in the identification of novel treatment targets. This study aimed to build upon past work documenting links between IU and ED symptoms by exploring changes in IU over treatment and links between early change in IU (1-month) and discharge symptoms. Participants (N = 274) receiving partial hospitalization treatment completed the Eating Pathology Symptoms Inventory and Intolerance of Uncertainty Scale at admission, 1-month post-admission, and discharge. Results suggested that IU significantly reduced from admission to discharge and that reductions in IU scores from admission to 1-month related to cognitive restraint, dietary restriction, and body image at discharge. However, this pattern did not hold for exercise, binge eating, or purging. Altogether, these results replicate past work supporting IU as a common feature across ED diagnoses and provide initial data suggesting that targeting IU early in treatment may enhance treatment outcomes.

Interoceptive awareness (IA), or the awareness of internal body states, is known to be impaired in individuals with eating disorders (EDs); however, little is understood about how IA and ED symptoms are connected. Network analysis is a statistical approach useful for examining how symptoms interrelate and how comorbidities may be maintained. The present study used network analysis to (1) test central symptoms within an IA-ED network, (2) identify symptoms that may bridge the association between IA and ED symptoms, and (3) explore whether central and bridge symptoms predict ED remission at discharge from intensive treatment. A regularized partial correlation network was estimated in a sample of 428 adolescent (n = 187) and adult (n = 241) ED patients in a partial hospital program. IA was assessed using items from the Multidimensional Assessment of Interoceptive Awareness, and ED symptoms were assessed using items from the Eating Disorder Examination-Questionnaire. Central symptoms within the network were strong desire to lose weight, feeling guilty, and listening for information from the body about emotional state. The most central symptom bridging IA and ED symptoms was (not) feeling safe in one's body. Of the central symptoms, greater desire to lose weight predicted lower likelihood of remission at treatment discharge. Bridge symptoms did not significantly predict remission. Body mistrust may be a mechanism by which associations between IA and EDs are maintained. Findings suggest targeting central and bridge symptoms may be helpful to improve IA and ED symptoms. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

BackgroundThe DSM-5 introduced purging disorder (PD) as an other specified feeding or eating disorder characterized by recurrent purging in the absence of binge eating. The current study sought to describe the long-term outcome of PD and to examine predictors of outcome.MethodsWomen (N = 84) who met research criteria for PD completed a comprehensive battery of baseline interview and questionnaire assessments. At an average of 10.24 (3.81) years follow-up, available records indicated all women were living, and over 95% were successfully located (n = 80) while over two-thirds (n = 58) completed follow-up assessments. Eating disorder status, full recovery status, and level of eating pathology were examined as outcomes. Severity and comorbidity indicators were tested as predictors of outcome.ResultsAlthough women experienced a clinically significant reduction in global eating pathology, 58% continued to meet criteria for a DSM-5 eating disorder at follow-up. Only 30% met established criteria for a full recovery. Women reported significant decreases in purging frequency, weight and shape concerns, and cognitive restraint, but did not report significant decreases in depressive and anxiety symptoms. Quality of life was impaired in the physical, psychological, and social domains. More severe weight and shape concerns at baseline predicted meeting criteria for an eating disorder at follow-up. Other baseline severity indicators and comorbidity did not predict the outcome.ConclusionsResults highlight the severity and chronicity of PD as a clinically significant eating disorder. Future work should examine maintenance factors to better adapt treatments for PD.

Appearance and performance-enhancing drugs and supplements (APEDS) are used to enhance muscle growth, athletic performance, and physical appearance. The aim of this study was to examine the lifetime use of APEDS and associations with eating disorder and muscle dysmorphia symptoms among cisgender sexual minority people.Participants were cisgender sexual minority people (1090 gay men, 100 bisexual plus men, 564 lesbian women, and 507 bisexual plus women) recruited from The PRIDE Study in 2018 who reported lifetime APEDS use and completed the Eating Disorder Examination-Questionnaire (EDE-Q) and the Muscle Dysmorphic Disorder Inventory (MDDI). Regression analyses stratified by gender and sexual orientation examined associations of any APEDS use with EDE-Q and MDDI scores.Lifetime APEDS use was common across the four groups of cisgender sexual minority people (44% of gay men, 42% of bisexual plus men, 29% of lesbian women, and 30% of bisexual plus women). Protein supplements and creatine supplements were the most commonly used APEDS. Any APEDS use was associated with higher EDE-Q scores on one or more subscales in all sexual minority groups. Further, any APEDS use was associated with higher MDDI Total Scores in all groups; any APEDS use was associated with all MDDI subscale scores in cisgender gay men only.APEDS use is common and associated with eating disorder and muscle dysmorphia symptoms in sexual minority men and women, thus highlighting the importance of assessing for these behaviors and symptoms among these populations in clinical settings.

The diagnostic operationalization of personality disorders is at the crossroads. The Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5), includes 2 separate systems for the diagnosis of personality disorders (PDs)-1 that is purely categorical (Section II) and 1 that is primarily dimensional (Section III). The International Classification of Diseases (11th ed.) will use a dimensional approach for the diagnosis of PDs. The Minnesota Multiphasic Personality Inventory 2-Restructured Form (MMPI-2-RF) PD Spectra scales were developed as measures of both the traditional and the alternative and scientifically supported systems. The current study examined the criterion and construct validity of these scales in a sample of 343 psychiatric patients. Patients completed the MMPI-2-RF, a measure of traditional personality disorders, a measure of the DSM-5 alternative model of personality disorder traits, and a measure of the 5-factor model of personality. Overall, with the exception of the Narcissistic and the Obsessive-Compulsive PD Spectra scales, the criterion and construct validity findings were quite supportive of these scales. Implications of these findings are discussed. (PsycINFO Database Record (c) 2020 APA, all rights reserved).