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Objective: Our ability to predict responsiveness to digital interventions for eating disorders has thus far been poor, potentially for three reasons: (1) there has been a narrow set of predictors explored; (2) prediction has mostly focused on symptom change, ignoring other aspects of the user journey (uptake, early engagement); and (3) there is an excessive focus on the unique effects of predictors rather than the combined contributions of a predictor set. We evaluated the univariate and multivariate effects of outcome predictors in the context of a randomized trial (n = 398) of digitally delivered interventions for recurrent binge eating. Method: Thirty baseline variables were selected as predictors, ranging from specific symptoms, to key protective factors, to technological acceptance, and to online treatment attitudes. Outcomes included uptake, early engagement, and remission. Univariate (d) and multivariate (D) standardized mean differences were calculated to estimate the individual and combined effects of predictors, respectively. Results: At the univariate level, few predictors produced an effect size larger than what is considered small (d >.20) across outcomes. However, our multivariate approach enhanced prediction (Ds =.65 to 1.12), producing accuracy rates greater than chance (63%–71% accuracy). Less than half of the chosen variables proved to be useful in contributing to predictions in multivariate models. Conclusion: Findings suggest that accuracy in outcome prediction from digitally delivered interventions may be better driven by the aggregation of many small effects rather than one or several largely influential predictors. Replication with different data streams (sensor, neuroimaging) would be useful. Public Significance: Our ability to predict who will and will not benefit from digital interventions for eating disorders has been poor. We highlight the viability of a multivariate approach to outcome prediction, whereby prediction may be better driven by the aggregation of many small effects rather than one or a few influential predictors. [ABSTRACT FROM AUTHOR]

Objective: Digital interventions show promise as an effective prevention or self‐management option for eating disorders (EDs). However, it remains unclear how, for whom, and through what mechanisms they work in this population, as a synthesis of outcome predictors, moderators, and mediators is lacking. This systematic review synthesized empirical research investigating predictors, mediators, and moderators of response to digital interventions for EDs. Method: Six databases were searched (PROSPERO CRD42022295565) for studies that assessed predictors, moderators, or mediators of response (i.e., uptake, drop‐out, engagement, and symptom level change) to a digital prevention or treatment program for EDs. Variables were grouped into several overarching categories (demographic, symptom severity, psychological, etc.) and were synthesized qualitatively across samples without a formally diagnosed ED (typically prevention‐focused) and samples with a formally diagnosed ED (typically treatment‐focused). Results: Eighty‐six studies were included. For studies recruiting samples without a formal diagnosis (n = 70 studies), most predictors explored were statistically unrelated to outcome, although participant age, baseline symptom severity, confidence to change, motivation, and program engagement showed preliminary evidence of prognostic potential. No robust moderators or mediators were identified. Few studies recruiting samples with a formal diagnosis emerged (n = 16), of which no reliable predictors, moderators, or mediators were identified. Discussion: It remains unclear how, for whom, and under what circumstances digital programs targeting EDs work. We offer several recommendations for future research with the aim of advancing understanding of client characteristics and intervention elements that signal success from this intervention modality. Public Significance: Digital interventions have shown potential as an effective, scalable, and accessible intervention option for EDs. However, responsiveness varies, so advancing understanding of predictors, mediators, and moderators of outcome to digital interventions for EDs is needed. Such knowledge is important for enabling safe and efficient treatment matching, and for informing future development of effective digital interventions. [ABSTRACT FROM AUTHOR]

Objective Method Results Conclusion Public Significance Theoretical models highlight body image disturbances as central to the maintenance of eating disorders, with empirical evidence finding negative body image to be a robust predictor of treatment nonresponse, relapse and symptom persistence. Accessible, scalable, and inexpensive interventions that can effectively target negative body image across the eating disorders are needed. We developed an online single session intervention (SSI) for negative body image and evaluated its acceptability and efficacy in a randomized controlled trial in individuals with recurrent binge eating.Participants with recurrent binge eating were randomly assigned to the SSI (n = 99) or a waitlist (n = 101). Assessments were conducted at baseline, 4 week follow‐up, and 8 week follow‐up.81% of participants accessed the SSI, demonstrating reasonable uptake. However, issues with attrition were apparent; a 32% study dropout rate was observed at posttest, while a 58% dropout rate was observed at follow‐up. 87% of participants who completed satisfaction measures would recommend the SSI. SSI participants experienced greater improvements in negative body image at both 4 (d = −0.65) and 8 week (d = −0.74) follow‐up. Significant between‐group effects were also observed on most other secondary symptom measures, though no differences were found for motivations and help‐seeking beliefs and intentions.Body image‐focused self‐guided SSIs for recurrent binge are largely accepted by those who are retained in the trial, but are associated with significant attrition. Although SSIs are not intended to replace standard treatment, they may help with short‐term symptom management and could play an important role in eating disorder care.Single session interventions (SSI) are a potentially accessible, scalable, and cost‐effective way to deliver evidence‐based treatment content to people with eating disorders. This study shows that an online (SSI) designed to target body image among people with recurrent binge eating is accepted and produced short‐term symptom relief. [ABSTRACT FROM AUTHOR]

Eating disorders (EDs) are characterized by multifaceted etiologies, difficulties in accessing care (especially in regional locations), and variable responsiveness to treatments. Digital technologies are viewed as an important innovation in the assessment and treatment of EDs. We discuss current implementation of these innovations as well as important future directions for the field. [ABSTRACT FROM AUTHOR]

Schleider et al. propose that single session interventions (SSIs) could be a promising path toward catalyzing innovation in the development of accessible interventions for eating disorders (EDs). In this commentary, we contend that the arguments made by Schleider et al. raise many unresolved questions that continue to arise in the broader field. Drawing from our experiences with—and lessons learned from—developing, evaluating, and disseminating digital health interventions, we discuss four key empirical questions that should be addressed in order to realize the full potential of SSIs and other innovations in intervention delivery. These include: (i) for whom do we deliver an SSI; (ii) what are the optimal treatment mechanisms to target; (iii) what constitutes a "good" outcome; and (iv) where and how might we embed innovations like these. The SSI approach is a fruitful area of research enquiry, and we hope that this commentary generates further discussion and high‐quality, collaborative work related to improving treatment accessibility and clinical outcomes among people with EDs. [ABSTRACT FROM AUTHOR]

The current study used ecological momentary assessment (EMA) to investigate whether appearance-based comments, social and performance-based evaluations affected levels of body dissatisfaction (BD) and urges to engage in disordered eating behaviors (DE) throughout daily life. A total of 620 participants completed a baseline questionnaire assessing sociodemographic variables. Participants then downloaded a mobile app which alerted them to complete short surveys assessing their levels of BD, DE urges, and experiences of receiving comments and evaluations six times per day for 7 days. Negative appearance-based comments predicted greater levels of state BD, while positive appearance comments predicted lower levels of state BD. Negative social and performance-based evaluations predicted an increase in state BD, while positive evaluations predicted a decrease in this outcome variable. No significant predictor was found for the DE urge outcomes. The present findings suggest that receiving negative and positive feedback in various domains of one's life may predict opposite outcomes for body image. However, these effects do not necessarily associate with urges to engage in DE in a nonclinical population. [ABSTRACT FROM AUTHOR]

Background: Inflammatory bowel disease (IBD) is a common and debilitating disease of the gastrointestinal tract. Psychological distress is highly comorbid to IBD, especially during periods of active disease. However, a controversy exists on how to best manage its symptoms in the IBD population. Aims: This study aimed to explore protective and risk factors of psychological distress in IBD. Methods: A cross-sectional online survey was conducted via social media and online patient forums. Respondents (N = 235) filled out questionnaires on demographics, health characteristics and a range of psychological variables. Measures of pain, disease activity, comorbid functional symptom severity, social support, subjective wellbeing, sleep quality, fatigue, stress, age, BMI and gender were entered into the Classification and Regression Tree Analysis model. Results: Overall, 87 participants (37%) reported distress. Self-reported stress significantly discriminated between cases of probable psychological distress. In those with high stress, patients with and without probable psychological distress were separated by subjective wellbeing. Among patients with low stress, fatigue was the primary discriminator. Conclusions: Monitoring patients for low subjective wellbeing and high stress in clinical settings could offer an opportunity to engage in early intervention to limit psychological distress development. Monitoring for fatigue in patients who seem otherwise psychologically well could offer preventative benefits. [ABSTRACT FROM AUTHOR]

Objective: Digital interventions show promise to address eating disorder (ED) symptoms. However, response rates are variable, and the ability to predict responsiveness to digital interventions has been poor. We tested whether machine learning (ML) techniques can enhance outcome predictions from digital interventions for ED symptoms. Method: Data were aggregated from three RCTs (n = 826) of self‐guided digital interventions for EDs. Predictive models were developed for four key outcomes: uptake, adherence, drop‐out, and symptom‐level change. Seven ML techniques for classification were tested and compared against the generalized linear model (GLM). Results: The seven ML methods used to predict outcomes from 36 baseline variables were poor for the three engagement outcomes (AUCs = 0.48–0.52), but adequate for symptom‐level change (R2 =.15–.40). ML did not offer an added benefit to the GLM. Incorporating intervention usage pattern data improved ML prediction accuracy for drop‐out (AUC = 0.75–0.93) and adherence (AUC = 0.92–0.99). Age, motivation, symptom severity, and anxiety emerged as influential outcome predictors. Conclusion: A limited set of routinely measured baseline variables was not sufficient to detect a performance benefit of ML over traditional approaches. The benefits of ML may emerge when numerous usage pattern variables are modeled, although this validation in larger datasets before stronger conclusions can be made. [ABSTRACT FROM AUTHOR]

Objective: This study qualitatively explored the experience of depression and body image concerns in women diagnosed with depression in the postpartum period. Background: Women's bodies undergo substantial changes during the perinatal period which can impact their body image and mood post-birth.However, it remains unknown how women diagnosed with depression experience their body image in the postpartum period. Methods: Seventeen women in their firstpostpartumyear completed qualitative telephone interviews: seven women diagnosed with depression and ten without depression. Thematic content analysis identified the main themes of the women's narratives: 1) expectations and adjustments to motherhood; 2) mood in response to changing postpartum body; 3) the context of feeling bad about my body; and 4) body letting me down and relationship to mood. Results: Differences in the relationship between body image and mood for postpartum women with depression compared to women without depression were revealed. Other themes seemed to be experienced in the same way by women with and without depression. Conclusion: Poor body image and depressive symptoms appear linked during postpartum. An improved understanding of this association may assist postpartum women to manage negative body image post-birthand prevent the exacerbation of negative emotional health in this period. [ABSTRACT FROM AUTHOR]

Objective: Although exercise is typically found to improve body satisfaction, this effect may be reduced or even reversed for trait body-dissatisfied individuals. The reasons for this remain unclear. This study tested the possibility that these effects are due to appearance-related motives and/or increased appearance awareness post-exercise.Method: Participants included 178 women who completed baseline measures of trait body dissatisfaction, and then completed an experience sampling phase in which they self-reported state body satisfaction and appearance awareness levels, and recent exercise experiences at six time-points daily for 10 days.Results: Trait body-dissatisfied individuals were more likely to exercise for appearance-related reasons, and experienced less of an increase in state body satisfaction post-exercise. Appearance-motivated exercise also increased appearance awareness. After controlling for appearance motives, the moderating effect of trait body dissatisfaction on the exercise-state body satisfaction relationship reduced to non-significance.Conclusions: Collectively, the present findings offer some support for both motive- and appearance awareness-based explanations for the reduced benefits of exercise on body satisfaction exhibited in individuals with trait body dissatisfaction. Targeting the reasons for exercise and what one focuses on during exercise may be viable ways to overcome potential negative impacts of exercise on body image for these individuals. Statement of contribution What is already known on this subject? While the physical and psychological benefits of exercise are well established, recent findings suggest that these benefits for body satisfaction may be reduced (and possibly reversed) for individuals with elevated trait body dissatisfaction. The reasons for this moderating effect remain unclear. What does this study add? Trait body-dissatisfied individuals more often engaged in exercise for appearance-related reasons. Appearance motives for exercise are associated with smaller body satisfaction gains post-exercise. Reduced body satisfaction was also linked to increased appearance awareness post-exercise. [ABSTRACT FROM AUTHOR]

Objective: The current study used network analysis to explore associations between specific groupings of borderline personality disorder (BPD) and eating disorder (ED) symptoms, and other transdiagnostic variables including insecure attachment, rejection sensitivity, emotion dysregulation, a theory of mind, and emotion recognition. Method: Network analysis was undertaken on self‐report data from 753 adults (81.5% women), of whom 109 reported a lifetime ED diagnosis. Results: Comorbidity between BPD and ED symptoms was only partially conceptualized through the transdiagnostic variables. The centrality indices from the network analysis indicated that emotion dysregulation and abandonment were the most central elements in the network. Conversely, the theory of mind and emotion recognition had very few connections with the other transdiagnostic variables in the network. Discussion: The findings provide empirical insight into the nature of the observed co‐occurrence between BPD and ED symptoms and serve to improve clinical decision‐making regarding psychological interventions for both problem sets. [ABSTRACT FROM AUTHOR]

Objectives: Although the efficacy of smartphone-delivered interventions for mental health problems is emerging, randomized controlled trials (RCTs) of smartphone interventions are characterized by high rates of attrition and low adherence. High attrition and low adherence may threaten the validity of RCT findings, so a better understanding of these phenomena is needed. We examined attrition and adherence in 70 RCTs of smartphone interventions. Method: Four online databases were searched for RCTs of mental health interventions delivered via smartphones. Results: The mean meta-analytic study attrition rate was 24.1% (95% CI [19.3, 29.6]) at short-term follow up and 35.5% (95% CI [26.7, 45.3]) at longer-term follow up. These rates varied according to target mental health condition. Attrition rates were significantly lower in trials that delivered an acceptance-based intervention, offered participants monetary compensation, and reminded participants to engage in the intervention, and were significantly higher in trials that used an online enrollment method (relative to telephone or in-person enrollment). No participant-level baseline characteristic reliably predicted attrition. Evidence of attrition bias came from many RCTs not conducting intention-to-treat analyses. However, the mean difference in the between-groups effect size on primary outcomes in trials that reported both per protocol an intention-to-treat analyses was only Ad = 0.18. Adherence rates were also suboptimal based on our qualitative synthesis; several participants failed to download the intervention, and intervention usage consistently declined over the course of the trial. Conclusion: Study attrition and low adherence are common, problematic, and may undermine the validity of findings in RCTs of smartphonedelivered interventions for mental health problems. [ABSTRACT FROM AUTHOR]

Objective Method Results Discussion A growing body of research, primarily cross‐sectional, suggests a relationship between the practice of tracking one's food intake and exercise behaviors using fitness‐tracking smartphone applications (“apps”) or wearable devices (“wearables”) and disordered eating symptomatology. The aim of the present study was to explore longitudinal relationships between fitness tracking and disordered eating outcomes among college‐aged women, as well as to determine whether the individual‐level risk factors of pre‐existing eating concerns, perfectionism, and rumination about food moderated the relationship.N = 68 female undergraduates used the MyFitnessPal app for 8 weeks while completing a series of self‐report measures.At the trait level, fitness tracking frequency was positively associated with weight/shape concerns, but not with the other outcome measures. Daily levels of fitness tracking did not predict next‐day levels for any of the outcome measures. Within‐day fitness tracking at one timepoint was associated with lower reports of dietary restraint efforts at the next timepoint. None of the proposed moderators significantly interacted with the relationships over time.These results suggest that while those who engage in fitness tracking may experience higher weight/shape concerns as a trait, over time fitness tracking was not associated with an increase in concerns. Further work exploring whether fitness tracking may affect particular subgroups in different ways is warranted. [ABSTRACT FROM AUTHOR]

The coronavirus disease 2019 (COVID‐19) pandemic led to a global surge in videoconferencing use for work/study‐related reasons. Although these platforms heighten exposure to one's image, the implications of videoconferencing use on body image and eating concerns remain scantly examined. This study sought to investigate, in an Australian sample, whether videoconferencing for work/study‐related reasons predicted increases in body dissatisfaction (BD), urge to engage in disordered eating (DE; restrictive eating, exercise, overeating/purging), and negative mood at the state level. Participants (N = 482, 78.8% women, Mage = 20.5 years [SD = 5.3]) completed baseline demographic measures, accompanied by an ecological momentary assessment (EMA) of videoconferencing for work/study‐related reasons, BD, DE urges, and negative mood six times a day for 7 days via a smartphone application. Most participants (n = 429; 89.0%) reported state‐based videoconferencing use during the EMA phase. Consistent with expectations, state‐based videoconferencing use was associated with an increase in state‐level urges to engage in exercise. However, contrary to predictions, state‐based videoconferencing use was linked to a decrease in state‐level BD at the next assessment point and failed to predict negative mood and urges to engage in restrictive eating or overeating/purging at the state level. Given the simplified measure of videoconferencing use, the current research is considered preliminary and future replication and extension, using more nuanced measures, is warranted. Highlights: State videoconferencing use predicted increased urges for exercise, but not negative mood, or urges for binge‐eating/purging or restrictive eatingState videoconferencing use predicted decreased body dissatisfaction (i.e., increased body satisfaction)Encourage future research into the nuances of videoconferencing use and potential consequences of interface design features [ABSTRACT FROM AUTHOR]

This study examined the sustained and moderating effects of a behavioural sleep intervention for autistic children in a randomised controlled trial. Autistic children (5–13 years) with sleep problems were randomised to the Sleeping Sound intervention or Treatment as Usual (TAU). At 12-month follow-up (n = 150), caregivers of children in the Sleeping Sound group reported greater reduction in child sleep problems compared to TAU (p <.001, effect size: − 0.4). The long-term benefits of the intervention were greater for children taking sleep medication, children of parents who were not experiencing psychological distress, and children with greater autism severity. The Sleeping Sound intervention demonstrated sustained improvements in child sleep. Identified moderators may inform treatment by indicating which subgroups may benefit from further support. [ABSTRACT FROM AUTHOR]

Types and stability of appearance-related social media use patterns remain under-explored despite established links between social media use and wellbeing. This study aimed to identify subgroups of social media users, and explore whether subgroup membership was stable over time and associated with body image-related outcomes. Adolescents (N = 766; M age = 12.76, SD = 0.73; 49.40% female) completed four surveys across 1-year, reporting several social media use indices, body dissatisfaction, dietary restraint, and strategies to increase muscle. Latent profile analyses identified two subgroups (moderate and high users), that remained reasonably stable over time. The high subgroup exhibited poorer body image at baseline, though differences seemed to dissipate somewhat over 1-year. Examination of subgroup transition over time showed more rapid increases in poor body image outcomes among social media increasers and more rapid declines for reducers. Prevention programs which aim to reduce high levels of social media use among children, young adolescents, and high-risk individuals (i.e., appearance-focused users) appear warranted. • Adolescents completed four surveys over 1-year. • Based on a range of social media indices, two subgroups were identified; moderate and high users. • High users reported poorer body image-related outcomes at baseline, but differences dissipated over 1-year. • Social media increasers reported rapid declines in body image, whereas reducers reported improvements. [ABSTRACT FROM AUTHOR]

Abstract Despite theoretical arguments that brief app-based interventions could be a useful adjunct to longer traditional treatment programs, there has been limited evaluation of the acceptability, feasibility, and efficacy of these micro-interventions. In the present study, 247 women from the general population were randomly assigned to the intervention or wait-list control condition, and provided measurement of body satisfaction and related constructs (body image importance, confidence dealing with body image issues, eating pathology, and self-esteem) at baseline and 21-days (post-intervention). During the 21-day period, the treatment group received access to an eHealth platform containing a series of brief video activities (e.g., gratitude tasks, breathing, and relaxation) previously demonstrated in experimental studies to improve body satisfaction. Findings showed greater improvements in body satisfaction at post-intervention for the intervention group than the waitlist controls (Cohen's d =.42). Use of the intervention content was associated with immediate increases in state-like body satisfaction ratings, and the magnitude of these in-the-moment improvements was predictive of greater post-intervention symptom improvement and retention (p s <.05). However, the intervention did not produce change in constructs related to body satisfaction (Cohen's d ranged from 0.02 to 0.13). Overall, findings offer support for micro-interventions as a spot treatment for specific symptoms, and possible means to maintain engagement and motivation within a broader treatment program. Highlights • We evaluated efficacy and acceptability of a micro-intervention for body satisfaction. • The content produced immediate symptom reduction at time of use and post-intervention. • Attrition rates were high, suggesting need to augment with motivational content. • Micro-interventions have potential as an adjunct to traditional therapies, such as CBT. [ABSTRACT FROM AUTHOR]

• The model showed acceptable fit for the three cultural groups individually. • Cross-cultural differences in the way interpersonal factors relate to DE were found. • Overall, appearance-RS mediated the effect of maladaptive schemas on DE. • Pathways were greatest in strength and number for the Caucasian-Australian group. The current study tested a new interpersonal model of disordered eating behaviours, whereby maladaptive schemas and theory of mind decoding (ToM-decoding) were related with disordered eating attitudes (body dissatisfaction) and behaviours (binging/purging and food restriction) through the mediating variable appearance-based rejection-sensitivity. A secondary aim was to test whether this model differed between two cultural groups: Caucasian Australian women (N = 197, ages ranging 17–43, M = 19.25, SD = 3.10), and Asian women living in East-Asia (N = 195, ages ranging 18–40, M = 28.60, SD = 5.15). Participants completed an online survey assessing the variables of interest. While the model showed acceptable fit for both groups, invariance testing demonstrated that the model worked differently in each group. Appearance-based rejection-sensitivity mediated the effect of maladaptive schemas on body dissatisfaction and disordered eating in both groups, but only mediated the effect of ToM-decoding on body dissatisfaction in the East-Asian group. Overall, the significant indirect pathways were greater in strength and number for the Caucasian-Australian group. These findings indicate that while the relationships between maladaptive schemas, appearance-based rejection-sensitivity, and disordered eating attitudes and behaviours are present in both cultures, ToM-decoding may only play a role for East-Asian participants. [ABSTRACT FROM AUTHOR]

Body checking and body avoidance, considered to be behavioural manifestations of core attitudinal disturbances of body image, are theorized to be important contributors to the development and maintenance of eating disorder symptoms. Currently, however, it is unclear whether body checking and body avoidance accounts for variance in disordered eating behaviours beyond core attitudinal components of body image (i.e., over-evaluation, preoccupation, dissatisfaction). This was the objective of the present study. Cross-sectional data were analysed from 320 females recruited through undergraduate psychology programs and throughout the community. Bivariate correlations demonstrated that body checking and avoidance were significantly and positively correlated with each attitudinal component and with each measure of disordered eating (overeating, objective binge eating, and disinhibition). However, body checking and avoidance did not contribute variance (all R2changes ≤ 0.01) to each disordered eating behaviour beyond the variance accounted for by attitudinal components. Future research should aim to identify what specific and unique function these body image behaviours serve. Overall, eating disorder prevention and early intervention programs may benefit from ensuring that all facets of body image concerns are targeted and addressed. [ABSTRACT FROM AUTHOR]

Objective: This study extends the dual pathway model (DPM) of bulimic symptoms by considering the bidirectional effects amongst symptoms of depression, dietary restraint, and bulimia. We also assessed the influence of negative urgency, a personality construct associated with bulimic symptoms, on the DPM. Method: Participants were 244 females (Mage = 23.77 years) from the general community. Variables pertinent to the DPM as well as negative urgency were assessed at baseline, and symptoms of depression, dietary restraint, and bulimia were reassessed at 1‐month follow‐up. Results: Excellent model fit was obtained once modifications were made to the DPM and the extended model that included negative urgency. Cross‐sectional paths replicated the DPM as hypothesized, with the exception that time 1 (T1) body mass index failed to predict T1 body dissatisfaction. Although no bidirectional effects were observed, T1 depression predicted dietary restraint at time 2 (T2). Negative urgency was shown to provide incremental predictive utility of T1 pressure to be thin, T1 body dissatisfaction, and T1 and T2 depression. Conclusion: Findings lend support to the DPM and suggest that depression might be a risk factor for later dietary restraint. The results are also consistent with the notion that negative urgency may be an independent risk factor for symptoms of bulimia. However, short‐term longitudinal effects of these putative risk factors require further evaluation. [ABSTRACT FROM AUTHOR]

This study examines a person-centered approach to self-regulated learning among 606 University students (140 online, and 466 in blended learning mode). Latent profile analysis revealed five distinct profiles of self-regulated learning: minimal regulators, restrained regulators, calm self-reliant capable regulators, anxious capable collaborators, and super regulators. These profiles showed that: (1) differences in academic success are associated with a learner’s capacity for motivational regulation and self-regulated learning strategy implementation, (2) online learners are more likely to belong to profiles that are more adaptive, and less reliant on collaborations with others, (3) for learners at the lower end of the self-regulation spectrum, an increase in both motivational regulation and adoption of self-regulated learning strategies may be academically beneficial, and (4) high motivational regulation and strategy adoption can be all for naught, if the student is also highly anxious with worry and concern regarding performance. [ABSTRACT FROM AUTHOR]

Dietary restriction contributes to disordered eating (DE) behaviors and associated cognitions. However, it is unclear how these outcomes are impacted by dietary restriction for religious purposes, such as fasting observed by Muslims during Ramadan. Using ecological momentary assessment, this study assessed the impact of Ramadan fasting on DE behaviors and correlates. Muslim participants fasting during Ramadan (n = 28) and a control group of non-fasting participants (n = 74) completed baseline measures assessing demographic characteristics and eating pathology. A mobile phone application then prompted participants six times per day for seven days to self-report on dietary restriction efforts, body satisfaction, temptation to eat unhealthily, feelings of guilt or shame following food, and DE behaviors including bingeing, vomiting, and other purging behaviors (use of laxatives, diuretics, or diet pills). After controlling for eating pathology, multilevel modeling indicated that, as expected, the Ramadan fasting group spent significantly more time restricting food intake than the non-fasting group. The Ramadan fasting group also experienced significantly greater temptation to eat unhealthily than their non-fasting counterparts. However, this difference disappeared once models were adjusted for differences in time spent restricting food intake. There were no other significant differences between the groups on any DE variables. These findings suggest that while dietary restriction for health or appearance-related reasons is a known contributor to DE, dietary restriction for religious purposes, such as that observed during the practice of Ramadan, may not confer increased risk of DE symptoms. [ABSTRACT FROM AUTHOR]

Objective: To validate the original and a shortened version of the Detail and Flexibility (DFlex) Questionnaire. Method: Confirmatory factor analyses, internal consistency, and discriminant validity estimates were conducted within individuals with a diagnosis of an eating disorder (ED) (n = 124), an anxiety disorder and/or depression (n = 219), and a community sample (n = 852) (Part 1). Convergent validity of the DFlex through comparisons with the Autism Spectrum Quotient, Wisconsin Card Sorting Task, and Group Embedded Figures Task was undertaken within a combined ED and community sample (N = 68). Test‐retest reliability of the DFlex was also examined across 2 years in a community sample (N = 85) (Part 2). Results: The original factor structure of the DFlex was not supported. Hence, a shortened version, the DFlex‐Revised, was developed. Good discriminant validity was obtained for the DFlex and DFlex‐Revised, however, support for convergent validity was mixed. Finally, the 2‐year test‐retest reliability for the two DFlex versions was found to be low, suggesting potential malleability in construct over this timeframe. Conclusions: Further research is needed to validate the DFlex in clinical and non‐clinical populations using different neurocognitive tests. Test‐retest, using varied time intervals, should also be assessed. Highlights: A revised shortened version of the DFlex (DFlex‐Revised) was developed.Findings support the factor structure of the DFlex‐Revised in eating disorders, anxiety/depression, and community groups.Good internal consistency and discriminant validity were obtained for both DFlex versions.The DFlex and DFlex‐Revised demonstrated some instability over a 2‐year period. [ABSTRACT FROM AUTHOR]

Using experience sampling methodology, we examined the effects of frequency and occurrence of appearance-based comparisons on disordered eating behaviors (binge eating, restrictive behaviors, and weight-related exercise). A total of 161 Australian women (aged 18–48) completed a baseline measure of eating pathology. An iPhone application prompted participants 6 times daily for 7 days to self-report on appearance comparisons and disordered eating behaviors since the last assessment. We hypothesized that contemporaneously reported occurrences of both upward and downward appearance comparisons, when compared to noncomparison situations, and frequency of upward comparisons would predict disordered eating behaviors. In prospective (lagged) analyses, only upward comparisons (relative to noncomparison situations) significantly predicted the likelihood of disordered eating outcomes. Trait eating pathology had a direct effect on each disordered eating variable and also moderated the influence of upward appearance comparisons (relative to noncomparison assessments) on binge-eating episodes. The lack of a differentiated effect between contemporaneously reported occurrences of upward and downward comparisons suggests that both forms of comparison increase the likelihood of disordered eating. Women may benefit from preventive programs that focus on the detrimental consequences of appearance comparisons on disordered eating; such programs may equip women with strategies to help reduce the frequency of these comparisons. [ABSTRACT FROM AUTHOR]

Background: The relationship between self-report trait level restriction and daily engagement in restriction behaviors is not well understood, and as a result the usefulness of such trait level measures is unclear. The present study aimed both to examine the validity of self-reported trait dietary restraint behaviors, and to examine the respective relationships among self-reported trait dietary restraint intentions and behaviors and both restrained and disinhibited eating at the daily level.Methods: A sample of 109 women (Mage = 24.72, SD = 4.15) completed a self-report trait level measure of dietary restraint before providing EMA data on their daily engagement in dietary restraint and disinhibited eating behaviors, as well as mood, over a period of 7 days. Multilevel hurdle models were used to test the relationship between trait levels of dietary restraint, and daily level reports of restraint and disinhibited eating behaviors.Results: Trait restraint behavior was a consistent predictor of daily presence and frequency of restraint behaviors. In contrast, trait restraint intentions was not a predictor of daily restraint behaviors, however it did predict daily frequency of overeating. In addition, daily negative affect emerged as a predictor of comfort eating, but was not predictive of restraint behaviors.Conclusions: Findings confirm the usefulness of assessments of self-reported trait dietary restraint behaviors as a method of capturing dieting behaviors. In contrast, trait level dietary restraint intentions was a poor predictor of eating outcomes and more research on the way that restraint intentions affect eating behaviors is warranted. [ABSTRACT FROM AUTHOR]

Research is scarce concerning the validity of subjective wellbeing measures for children aged 12 years and less. There are even fewer subjective wellbeing data for children with complex backgrounds and personal circumstances and those experiencing socio-demographic disadvantage. This study compares the psychometric properties of the child and adult versions of the Personal Wellbeing Index. Participants were 1761 'at-risk' children aged 10-12 years, and 2000 geographically representative Australian adults. While there was sufficient fit with a one-factor structure, the reliability estimates were lower in the child sample and the incidence of response bias was significantly higher. Collectively, these findings suggest caution in the use of subjective wellbeing measures with children. [ABSTRACT FROM AUTHOR]

Aim The current study aimed to assess insecure attachment and the disconnection and rejection domain of maladaptive schema in the context of disordered eating. Rejection sensitivity (RS) was proposed as a mediator between maladaptive schema and disordered eating. Method The sample consisted of 108 female participants with a lifetime eating disorder diagnosis and 508 female control participants. Participants were asked to complete a number of self-report measures related to insecure attachment (anxious and avoidant), maladaptive schema (emotional deprivation, abandonment, mistrust, social isolation, and defectiveness), RS (interpersonal and appearance-based), and disordered eating. Results Path analysis indicated that anxious attachment was associated with disordered eating through multiple pathways involving emotional deprivation, abandonment, interpersonal RS, and appearance-based RS. Avoidant attachment was not related to disordered eating behaviours. Conclusion The results indicate that both interpersonal and appearance-based RS are important mediators for the relationships between insecure attachment, maladaptive schema, and disordered eating. Key Practitioner Message The results from the current study suggest that insecure attachment leads to maladaptive schema, which in turn leads to sensitivity to rejection and subsequent disordered eating behaviour., Attachment anxiety, but not attachment avoidance, was related to greater endorsement of all five schemas in the disconnection and rejection domain., Path analysis revealed that, of the schema in the disconnection and rejection domain, only emotional deprivation and abandonment were related to disordered eating., Interpersonal and appearance-based rejection sensitivity were significant mediators of the relationship between emotional deprivation and disordered eating as well as the relationship between abandonment and disordered eating., Differentiating between schemas within schema domains has clinical value in further understanding the pathway to disordered eating., The schemas of emotional deprivation and abandonment are implicated in disordered eating, suggesting the need to target these schemas in schema therapy. [ABSTRACT FROM AUTHOR]

This study developed and validated a quantitative measure of body image specifically designed for pregnancy-the Body Image in Pregnancy Scale (BIPS). Scale development was guided by qualitative data from a series of studies exploring the meaning of women's body image experiences during pregnancy, and previously established body image measures. Exploratory factor analysis for a sample of pregnant women (n = 251) indicated good fit for a 36-item scale with seven factors: preoccupation with physical appearance, dissatisfaction with physical strength, dissatisfaction with facial features, sexual attractiveness, prioritizing physical appearance over body functioning, appearance-related behavioral avoidance, and dissatisfaction with body parts. BIPS subscale scores demonstrated good internal reliability, test-retest reliability, and both incremental and convergent validity with measures of body image, self-esteem, and depressive symptomatology. Although the pregnancy-focused wording of BIPS items prevents its use for comparisons with nonpregnant populations, further testing of changes in body image throughout pregnancy is an identified area for further research with this measure. (PsycINFO Database Record [ABSTRACT FROM AUTHOR]

Aim The current study assessed a new interpersonal model for eating disorders (EDs), in which interpersonal rejection sensitivity (RS), appearance-based RS and social rank were hypothesised to mediate the relationship between insecure attachment and disordered eating. Method The sample comprised a clinical ED group (N = 122) and a control group (N = 622). Participants were asked to complete a number of self-report measures related to the variables of interest. Results Invariance testing indicated that the model was structurally non-invariant (different across groups). For the ED group, appearance-based RS and social rank were significant mediators of the relationship between insecure attachment and disordered eating. For the controls, the relationship between insecure attachment and disordered eating was mediated through multiple pathways involving interpersonal RS, appearance-based RS and social rank. Conclusion These findings may inform existing therapies such as interpersonal psychotherapy for EDs, by emphasising the role of sensitivity to rejection in the development and maintenance of disordered eating. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association. [ABSTRACT FROM AUTHOR]

The past 2 decades have seen increasing use of experience sampling methods (ESMs) to gain insights into the daily experience of affective states (e.g., its variability, as well as antecedents and consequences of temporary shifts in affect). Much less attention has been given to methodological challenges, such as how to ensure reliability of test scores obtained using ESM. The present study demonstrates the use of dynamic factor analysis (DFA) to quantify reliability of test scores in ESM contexts, evaluates the potential impact of unreliable test scores, and seeks to identify characteristics of individuals that may account for their unreliable test scores. One hundred twenty-seven participants completed baseline measures (demographics and personality traits), followed by a 7-day ESM phase in which positive and negative state affect were measured up to 6 times per day. Analyses showed that although at the sample level, scores on these affect measures exhibited adequate levels of reliability, up to one third of participants failed to meet conventional standards of reliability. Where these low reliability estimates were not significantly associated with personality factors, they could-in some cases-be explained by model misspecification where a meaningful alternative structure was available. Despite these potential differences in factor structure across participants, subsequent modeling with and without these "unreliable" cases showed similar substantive results. Hence, the present findings suggest typical analyses based on ESM data may be robust to individual differences in data structure and/or quality. Ways to augment the DFA approach to better understand unreliable cases are discussed. (PsycINFO Database Record [ABSTRACT FROM AUTHOR]

Objective The present study aims to explore the potentially longitudinal bi-directional effects of disordered eating (DE) symptoms with depression and anxiety. Method Participants were 189 (49.5% male) adolescents from Melbourne, Australia. DE, depressive and anxiety symptoms were assessed at approximately 15, 16.5 and 18.5 years of age. Results Analysis of longitudinal bi-directional effects assessed via cross-lagged models indicated that DE symptoms of eating and shape/weight concerns were risk factors for anxiety. Results also showed that depression was a risk factor for eating concerns. Conclusion Our findings provide preliminary evidence that preventative measures designed to target concerns about eating and shape/weight might be most efficacious in reducing the transmission of effects between symptoms of DE, depression and anxiety. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association. [ABSTRACT FROM AUTHOR]

An increasingly popular form of data collection in health psychology research is Ecological Momentary Assessment (EMA); that is, using diaries or smartphones to collect intensive longitudinal data. This method is increasingly applied to the study of relationships between state-based aspects of individuals’ functioning and health outcomes (e.g., binge eating, alcohol use). Analysis of such data is challenging and regression tree modelling (RTM) may be a useful alternative to multilevel modelling for investigating the association between a set of explanatory variables and a continuous outcome. Furthermore, RTM outputs ‘decision trees’ that could be used by health practitioners to guide assessment and tailor intervention. In contrast to regression, RTM is able to easily accommodate many complex, higher-order interactions between predictor variables (without the need to create explicit interaction terms). These benefits make the technique useful for those interested in monitoring and intervening upon health and psychological outcomes (e.g., mood, eating behaviour, risky alcohol use, and treatment adherence). Using real data, this paper demonstrates both the benefits and limitations of RTM and how to extend these models to accommodate analysis of nested data; that is, data that arise from EMA where repeated observations are nested within individuals. [ABSTRACT FROM PUBLISHER]

This study tests relative contributions and time-course of proposed risk/protective factors (e.g., stress, coping, and lack of social interactions) for influencing depressed mood states in daily life. Seventy-three participants completed baseline measurement of major depressive disorder symptomatology, followed by smartphone app-based monitoring of momentary experiences of depressed mood and risk/protective factors for 7 days. All predictors had deteriorating impacts on mood as lag increased, and the optimal lag appears to be less than 120 min. Linear decay in effect sizes was found for physical activity, social interaction, and tiredness, whereas exponential decline in effect sizes was found for stress and coping ability. Stress, coping, and depressed mood at the prior time-point were the best predictors of subsequent mood. These effects did not differ as a function of trait depressive symptom severity. Findings highlight the influence of spacing of assessments in identification and magnitude of predictors of mood states, and provide insights into key drivers of change in mood and their time-course. [ABSTRACT FROM AUTHOR]

Objective: Prior reviews have shown that interventions targeting internalization of appearance standards are generally efficacious, though there is considerable heterogeneity in estimates across studies. This updated review of the literature evaluates whether efficacy estimates from RCTs systematically vary as a function of three related outcome measures (internalization, awareness, and perceived pressure regarding appearance standards). Methods: Seven electronic databases were systematically searched from inception to February 8, 2023. The Cochrane Risk of Bias tool assessed each study's risk of bias. Studies included were randomized‐controlled trials evaluating body image/eating disorder prevention or intervention programs targeting internalization as a focal point of treatment. Effect sizes were meta‐analyzed and meta‐regression analyses were conducted investigating the impact of outcome measure choice on study effect size at post‐intervention and follow‐up. Results: Thirty‐seven studies (N = 4809 participants) were included. The meta‐analytic findings as expected found interventions efficacious at reducing internalization post‐intervention (d = −0.47, 95% CI [−0.60 to −0.34], k = 44), and at follow‐up (d = −0.28, 95% CI [−0.39 to −0.17], k = 43), but also highly heterogenous (I2 = 52–67%). Operationalization of internalization moderated results at follow‐up but not post‐intervention timepoints, with awareness measures (compared with internalization measures) producing weaker effect sizes. Exploratory analyses found bigger effects when internalization was compared with all other measurement categories combined, suggesting possible issues with statistical power in main analyses. Discussion: Mixed present findings suggest need for further evaluation of measurement effects on efficacy, and possible caution in choice of outcome measure for internalization‐based interventions. Public significance statement: This review provides some preliminary evidence that choice of survey measures used in randomized controlled trials can impact our judgments about whether a trial reduces the extent to which participants endorse unrealistic appearance standards. Accuracy in measurement of this efficacy of trials is crucial, given the role that internalized appearance standards play in onset and maintenance of eating disorders. [ABSTRACT FROM AUTHOR]

Although the link between fat talk and body dissatisfaction is well established, the link between fat talk and other body image disturbance components remains underexplored. Our meta-analytic review explored the cross-sectional, experimental, and longitudinal relations between fat talk and body dissatisfaction, body surveillance, body shame, pressure to be thin, thin-ideal internalization, body checking, and appearance-based comparisons. We identified 35 relevant studies via electronic databases. Meta-analyses provided effect size estimates based on study design and whether fat talk was the predictor or outcome of body image disturbance. Results showed that fat talk is related to a broader range of body image constructs than just body dissatisfaction and that accumulated evidence from longitudinal and experimental studies—although limited in number—suggests it is more plausible that fat talk is a risk factor for these body image constructs, rather than a consequence of them. Nevertheless, the suggestion that fat talk may play a role in the causal sequence of body image issues highlights this as a potential area of intervention for researchers and clinicians. Given that fat talk is common and often well intentioned, awareness-raising exercises for parents and peers may be necessary to curb its incidence and impacts. Online slides for instructors who want to use this article for teaching are available on PWQ's website at http://journals.sagepub.com/page/pwq/suppl/index . [ABSTRACT FROM AUTHOR]

Although the influence of stable, trait-like factors (such as trait body dissatisfaction and appearance internalization) on instances of appearance comparison has been well documented, the additive and interactive influence of contextual factors (such as one's current body satisfaction) on comparison behaviors is unknown. Therefore, the present study tested a Person×Situation model in which both state and trait body image variables interacted to predict engagement in various forms of comparison (upward, downward, and lateral). Participants included 161 women who completed a baseline measure of trait body dissatisfaction and internalization, and then completed, via an iPhone app, an ecological momentary assessment phase in which they reported momentary experiences of mood and comparison behaviors at up to 6 random times per day for 7days. Multilevel analyses revealed that upward comparisons (comparisons against more attractive people) were more likely for individuals with heightened trait and/or state negative body image, but these predictive effects of state and trait on appearance comparisons appear largely independent of each other. Furthermore, neither state nor trait body image variables were related to the other forms of comparison, and time lag at the state-level between predictor and outcome did not seem to influence the strength of these associations. Present findings are consistent with the notion that how an individual feels in the moment about their appearance may influence engagement in deleterious appearance behaviors. However, further testing is needed to confirm these causal hypotheses. [ABSTRACT FROM AUTHOR]

The present study proposes and demonstrates a comprehensive framework for evaluation of a universal school-based depression prevention program. Efficacy was evaluated by considering the impact of continuous versus categorical approaches to operationalizing outcome, the effect of the intervention on key change agent variables, and moderation of intervention effects by student symptom severity at baseline. Participants 252 adolescent boys and girls (60 % male), aged 13 to 17 years (M = 13.62 years, SD = 0.60 years) from four schools in the state of Victoria, Australia, who were allocated by school into a waitlist = control (n = 88) or a CBT-based intervention (n = 164) group. The intervention involved six 45-min weekly sessions run during wellbeing classes. While the intervention and control groups did not differ in average improvement in symptoms by post-intervention, further analyses showed that responsiveness was highly variable within the intervention, and those with elevated depressive symptoms benefitted most. The proposed change agents of self-esteem, resilience, body image satisfaction, and perceived social support did not uniquely predict change in depressive symptoms but collectively accounted for substantial variance in this change process. Collectively, this framework provided insights into aspects of the intervention that worked and highlighted areas for improvement, thus providing clear direction for future research. [ABSTRACT FROM AUTHOR]

Background: Although accumulated evidence suggests that fluctuations in depressed mood are common among individuals with depression, and may be associated with onset, duration, and severity of illness, a systematic appraisal of putative predictors of depressed mood is lacking.Methods: A systematic search for relevant studies in the literature was conducted using PsycInfo and PubMed databases via EbscoHost in February 2016. The search was limited to articles using the experience sampling method, an approach suitable for capturing in situ fluctuations in mood states.Results: Forty-two studies met inclusion criteria for the review, from which three key risk factors (poor sleep, stress, and significant life events) and two protective factors (physical activity and quality of social interactions) were identified. The majority of papers supported concurrent and lagged associations between these putative protective/risk factors and depressed mood.Limitations: Despite support for each of the proposed protective/risk factors, few studies evaluated multiple factors in the same study. Moreover, the time course for the effects of these predictors on depressed mood remains largely unknown.Conclusions: The present review identified several putative risk and protective factors for depressed mood. A review of the literature suggests that poor sleep, negative social interactions, and stressful negative events may temporally precede spikes in depressed mood. In contrast, exercise and positive social interactions have been shown to predict subsequent declines in depressed mood. However, the lack of multivariate models in which the unique contributions of various predictors could be evaluated means that the current state of knowledge prevents firm conclusions about which factors are most predictive of depressed mood. More complex modeling of these effects is necessary in order to provide insights useful for clinical treatment in daily life of the depressed mood component of depressive disorders. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Undertake a meta-analysis to provide a quantitative synthesis of longitudinal studies that assessed the direction of effects between eating pathology and depression. A second aim was to use meta-regression to account for heterogeneity in terms of study-level effect modifiers. Method A systematic review was conducted on 42 studies that assessed the longitudinal relationship between eating pathology and depression. Of these 42 studies, multilevel random-effects meta-analyses were conducted on 30 eligible studies. Results Meta-analysis results showed that eating pathology was a risk factor for depression ( rm = 0.13) and that depression was a risk factor for eating pathology ( rm = 0.16). Meta-regression analyses showed that these effects were significantly stronger for studies that operationalized eating pathology as an eating disorder diagnosis versus eating pathology symptoms, and for studies that operationalized the respective outcome measure as a categorical variable (e.g., a diagnosis of a disorder or where symptoms were 'present'/'absent') versus a continuous measure. Results also showed that in relation to eating pathology type, the effect of an eating disorder diagnosis and bulimic symptoms on depression was significantly stronger for younger participants. Discussion Eating pathology and depression are concurrent risk factors for each other, suggesting that future research would benefit from identifying factors that are etiological to the development of both constructs. Resumen Objetivo Llevar a cabo un meta-análisis para proporcionar una síntesis cuantitativa de los estudios longitudinales que evaluaron la dirección de los efectos entre la alimentación patológica y la depresión. Un segundo objetivo fue utilizar la meta-regresión para dar cuenta de la heterogeneidad en términos de modificadores del efecto a nivel de estudio. Método Una revisión sistemática se llevó a cabo en 42 estudios que evaluaron la relación longitudinal entre la alimentación patológica y la depresión. De estos 42 estudios, se realizaron meta-análisis de multinivel de efectos aleatorios en 30 estudios elegibles. Resultados Los resultados del meta-análisis mostraron que la alimentación patológica era un factor de riesgo para depresión (rm=0.13) y que la depresión era un factor de riesgo para la alimentación patológica (rm=0.16). Los análisis de meta-regresión mostraron que estos efectos eran significativamente más fuertes para estudios que operacionalizaban la alimentación patológica como un diagnóstico de trastorno de la conducta alimentaria versus síntomas de alimentación patológica, y para los estudios que operacionalizaban la medida respectiva de resultado como una variable categórica (e.g., un diagnóstico de trastorno o cuando los síntomas estaban 'presentes'/'ausentes') versus una medida continua. Los resultados mostraron que en relación al tipo de alimentación patológica, el efecto de un diagnóstico de trastorno de la conducta alimentaria y síntomas bulímicos en la depresión era significativamente más fuerte para participantes más jóvenes. Discusión La alimentación patológica y la depresión son factores de riesgo concurrentes uno para el otro, lo que sugiere que la investigación futura se beneficiaría de identificar factores que son etiológicos al desarrollo de ambos constructos. © 2015 Wiley Periodicals, Inc. (Int J Eat Disord 2016;49:439-454) [ABSTRACT FROM AUTHOR]

Understanding subjective wellbeing (SWB) at the population level has major implications for governments and policy makers concerned with enhancing the life quality of citizens. The Personal Wellbeing Index (PWI) is a measure of SWB with theoretical and empirical credentials. Homeostasis theory offers an explanation for the nature of SWB data, including the distribution of scores, maintenance and change over time. According to this theory, under normal conditions, the dominant constituent of SWB is Homeostatically Protected Mood (HPMood), which is held within a genetically determined range of values around a set-point. However, in extreme circumstances (e.g., financial hardship, chronic illness), HPMood may dissociate from SWB, as cognitive/emotional reactions to the cause of homeostatic challenge assume control over SWB. This study investigates two groups as people scoring in the positive range for SWB and people who are likely to be experiencing homeostatic defeat/challenge. We test whether the reduced influence of HPMood on SWB due to homeostatic defeat has implications for the validity of SWB measurement. Participants were 45,192 adults (52 % female), with a mean age of 48.88 years (SD = 17.35 years), who participated in the first 23 surveys of the Australian Unity Wellbeing Index over the years 2001-2010. Multiple regression analysis, multiple group confirmatory factor analysis, and Rasch modelling techniques were used to evaluate the psychometric performance of the PWI across the two groups. Results show that while the PWI functioned as intended for the normal group, SWB in the challenged group was lower across all PWI domains, more variable, and the domain scores lacked the strength of inter-correlation observed in the normal, comparison group. These changes are consistent with predictions based on homeostasis theory and one major implication of the findings is that SWB measures may not function equivalently across the entire spectrum of possible domain satisfaction scores. [ABSTRACT FROM AUTHOR]

Purpose: While intervention effects in target outcomes have typically been tested based on change from baseline to post-intervention, such approaches typically ignore individual differences in change, including time taken to see improvement. The present study demonstrates how weekly patient-reported data may be used to augment traditional pre-post intervention evaluations in order to gain greater insights into treatment efficacy.Methods: Two hundred and fifty-two adolescent boys and girls (M age = 13.6 years, SD = 0.6 years) from four secondary schools in Victoria, Australia, were assigned by school into control (n = 88) or intervention (n = 164) groups. The intervention group participated in a 6-week course designed to improve subjective wellbeing (SWB) by fostering resilience, coping skills, and self-esteem. In addition to baseline, post-intervention, and 3-month follow-up assessments of SWB, intervention group participants also completed weekly summarise of affective experiences for the duration of the intervention phase.Results: While standard pre-post data showed significant improvement in SWB for the intervention group relative to controls, weekly data showed individual differences in the trajectory of change during this intervention phase; low SWB individuals experienced initial worsening of symptoms followed by improvement in the second half of the intervention phase, whereas high SWB individuals experienced initial gains, followed by a plateau from Week 4 onwards.Conclusions: Addition of weekly data provided greater insights into intervention effects by: (1) contradicting the notion that early responsiveness to treatment is predictive of level of improvement by post-intervention, and (2) providing data-based insights into ways to enhance the intervention. [ABSTRACT FROM AUTHOR]

Objective: To examine a new socio-family risk model of Eating Disorders (EDs) using path-analyses.Method: The sample comprised 1264 (ED patients = 653; Healthy Controls = 611) participants, recruited into a multicentre European project. Socio-family factors assessed included: perceived maternal and parental parenting styles, family, peer and media influences, and body dissatisfaction. Two types of path-analyses were run to assess the socio-family model: 1.) a multinomial logistic path-model including ED sub-types [Anorexia Nervosa-Restrictive (AN-R), AN-Binge-Purging (AN-BP), Bulimia Nervosa (BN) and EDNOS)] as the key polychotomous categorical outcome and 2.) a path-model assessing whether the socio-family model differed across ED sub-types and healthy controls using body dissatisfaction as the outcome variable.Results: The first path-analyses suggested that family and media (but not peers) were directly and indirectly associated (through body dissatisfaction) with all ED sub-types. There was a weak effect of perceived parenting directly on ED sub-types and indirectly through family influences and body dissatisfaction. For the second path-analyses, the socio-family model varied substantially across ED sub-types. Family and media influences were related to body dissatisfaction in the EDNOS and control sample, whereas perceived abusive parenting was related to AN-BP and BN.Discussion: This is the first study providing support for this new socio-family model, which differed across ED sub-types. This suggests that prevention and early intervention might need to be tailored to diagnosis-specific ED profiles. [ABSTRACT FROM AUTHOR]

This study examined, within the context of the Contingencies of Self-Worth model, state-based associations between self-esteem and body satisfaction using the experience sampling method. One hundred and forty-four adolescent girls (mean age = 14.28 years) completed up to 6 assessments per day for one week using Palm Digital Assistants, in addition to baseline measures of trait body satisfaction and self-esteem. Results showed considerable variation in both state-based constructs within days, and evidence of effects of body satisfaction on self-esteem, but not vice versa. Although these state-based associations were small in size and weakened as the time lag between assessments increased for the sample as a whole, individual differences in the magnitude of these effects were observed and predicted by trait self-esteem and body satisfaction. Collectively, these findings offer support for key tenets of the Contingencies of Self-Worth model. [ABSTRACT FROM AUTHOR]

Background: The network approach has emerged as a useful framework for conceptualizing and investigating psychopathology, including eating disorders. Network connectivity, that is, the density of the connections among network nodes, has been somewhat neglected despite its theoretical relevance. As predicted by network theory, symptom connectivity would be distinct but related to symptom severity and may be a useful clinical indicator of psychopathology as stronger and/or more diffuse connections among symptoms offer more avenues for symptom activation. This study aimed to investigate the relationship between moment‐by‐moment individual‐level symptom connectivity and global levels of symptom severity in the context of eating disorder symptoms and experiences. Methods: A sample of 58 female undergraduate college students, mean (SD) age = 20.5 (3.1) provided data on eating disorder symptoms eight times a day over the course of 10 days. Network analyses were used to calculate the eating disorder symptoms network connectivity for each participant. In addition, participants completed survey of self‐report measures of eating disorder symptom severity and trait mindfulness and body image flexibility. Results: Analyses revealed a moderate, positive relationship between individual network connectivity and eating disorder symptom severity. In addition, symptom connectivity predicted unique variance of symptom severity even after controlling for other clinically‐relevant variables. Conclusions: Individual‐level network connectivity may be an important dimension of psychopathology and further work exploring the role of network connectivity is warranted. Public Significance: These findings suggest that symptom severity and the extent to which different eating disorder symptoms are connected are related but different dimensions. Investigating how these different dimensions play a role in eating disorder pathology could help to better understand and treat these disorders. [ABSTRACT FROM AUTHOR]

Rates of overweight and obesity increase significantly whilst children and young people are in out-of-home care. This paper provides the protocol for a study, funded by the Australian Research Council (2012–2014), being conducted to evaluate the effectiveness of a Healthy Eating and Active Living intervention programme for adolescents who live in out-of-home residential care. This randomised trial will be conducted with 118 adolescents aged 13–17 years of age in out-of-home residential care and the residential staff who look after them. Adolescents' eating habits, physical activity levels, psychological well-being, body dissatisfaction and weight status will be assessed at baseline, immediately post the programme (which runs for 6 months), and again 12 months post baseline. Similar measures will be obtained from residential carers (across the same time points). If effective, this programme could be implemented as usual care to modify levels of obesity amongst these vulnerable young people. [ABSTRACT FROM PUBLISHER]

To date, there has been limited empirical scrutiny of the correlates and consequences of day-to-day state body dissatisfaction fluctuations within naturalistic contexts. We used ecological momentary assessment (a form of naturalistic observation) to evaluate whether state body dissatisfaction was concurrently and/or prospectively associated with occurrence and quality of social interactions. Women (N = 121), aged 18 to 40, completed a brief trait-based survey and then nominated a 7-day period within which to receive seven text messages daily, at random intervals, prompting them to complete measures of body dissatisfaction at that moment. If they were currently or had recently engaged in social interactions, they were also asked to fill out questions rating the quality of these interactions (operationalized in terms of enjoyment of, and control in, the interaction). Findings suggest that the relationship between state body dissatisfaction and aspects of social interactions is complex and may vary over time. Cross-sectionally, state body dissatisfaction and social interaction quality were negatively associated. Prospectively, however, body dissatisfaction predicted subsequent avoidance of social interactions. Interestingly, when women chose to avoid social interactions, their body dissatisfaction worsened, yet when they did engage in social interactions, they reported improved body satisfaction. Importantly, the links between state body dissatisfaction and social interactions may be moderated by body mass index and trait body satisfaction levels. Potential mechanisms underlying the association between state body dissatisfaction and quality and quantity of social interactions are discussed, and future research avenues are proposed to further understand their inter-relation. [ABSTRACT FROM PUBLISHER]

This study evaluates the influences of chronicity of, and time lag between, dietary restriction and binge outcome for predicting binge episode onset. Sixty-two women aged 18 to 40 years old completed an online survey at random intervals seven times daily for a 7-day period. Participants self-reported engagement in dietary restriction and/or binging, and temptation to binge. Consecutive instances of reported dietary restriction better predicted subsequent binges than single instances. As the time lag between the first report of dietary restriction and binge onset increased, a clear linear trend emerged, such that the value of restriction for predicting binges increased with the number of consecutive assessments in which they reported dietary restriction. A similar pattern was found when predicting temptation to binge. Present findings suggest that duration of restriction is a crucial determinant of binge onset. These findings have implications for clinical practice by highlighting the time course from dietary restriction to binging. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association. [ABSTRACT FROM AUTHOR]

Objective.This study aimed to identify cultural-level variables that may influence the extent to which adolescents from different cultural groups are dissatisfied with their bodies. Design.A sample of 1730 male and 2000 female adolescents from Australia, Fiji, Malaysia, Tonga, Tongans in New Zealand, China, Chile, and Greece completed measures of body satisfaction, and the sociocultural influences on body image and body change questionnaire, and self-reported height and weight. Country gross domestic product and national obesity were recorded using global databases. Results.Prevalence of obesity/overweight and cultural endorsement of appearance standards explained variance in individual-level body dissatisfaction (BD) scores, even after controlling for the influence of individual differences in body mass index and internalization of appearance standards. Conclusions.Cultural-level variables may account for the development of adolescent BD. [ABSTRACT FROM AUTHOR]

Abstract: The dual pathway model proposes that trait body dissatisfaction leads to bulimic symptoms via two distinct pathways: dieting and trait negative affect. As many of these modelled variables have state-based equivalents, the present study evaluated the generalisability of this model to predict associations between state body dissatisfaction and instances of disordered eating. 124 women aged 18 to 40years completed an online survey (accessed via a mobile phone device with web access) over a 7-day period. The mobile phone device prompted participants at random intervals seven times daily to self-report their state body dissatisfaction, current mood experiences, dieting attempts, and disordered eating practices. Multi-level mediation modelling revealed that both negative mood states and dieting significantly mediated the state body dissatisfaction–disordered eating relationships, although the strength of these associations depended on the aspect of disordered eating measured and individual differences in trait body dissatisfaction, internalization of appearance standards, tendency towards dieting, and BMI. Collectively, these results not only support adapting the dual pathway model to the state-level, but also suggest that several of the model implied pathways may be more relevant for individuals with more pathological eating- and body-related concerns and behaviours. [Copyright &y& Elsevier]

Despite increasing research interest in the subjective wellbeing (SWB) of Indigenous Australians, SWB measures used in these studies have not been validated for use in this population. Until the measurement equivalence of scales used in this population are demonstrated, inferences regarding potential differences in SWB across Indigenous and non-Indigenous groups cannot be validly inferred. To rectify this, the present study examines the psychometric equivalence of the Personal Wellbeing Index-School Children (PWI-SC) for use among samples of Indigenous and non-Indigenous Australian adolescents using multiple-group confirmatory factor analysis. The Indigenous sample comprised 1,378 adolescents enrolled in the Australian Federal Government's Youth Connections Program. A sample of 6,401 non-Indigenous adolescents also enrolled in the Youth Connections Program represented a second comparative group. Finally, the third comparative group comprised a convenience sample of 983 Victorian high-school students. The results demonstrated strict factorial invariance between all three adolescent groups, suggesting that the PWI-SC measures the same underlying construct in each sample. These findings support quantitative comparisons between Indigenous and non-Indigenous SWB data as valid. The implications of this research are discussed. [ABSTRACT FROM AUTHOR]