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Guan W, Su W, Ge H, Dong S, Jia H, Liu Y, Yu Q, Qi Y, Zhang H, Ma G. A study on the identification of factors related to depression in a population with an increasing number of chronic diseases in the short term in China based on a health ecology model. J Affect Disord 2024; 368:838-846. [PMID: 39293598 DOI: 10.1016/j.jad.2024.09.090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 07/17/2024] [Accepted: 09/14/2024] [Indexed: 09/20/2024]
Abstract
BACKGROUND The rapid increase in the number of patients with chronic diseases and depression, as well as the rapid spread of their effects, have led to these two health problems gradually developing into major public health issues in China and around the world. Currently, many individuals with chronic diseases are experiencing depressive symptoms one after another. Therefore, it is imperative to conduct research on how to prevent depression in this growing population of individuals with chronic diseases in a timely manner. METHODS Based on the data of the 2015 and 2018 national follow-up surveys of the China Health and Retirement Longitudinal Study, a total of 7641 patients with short-term increase in the number of chronic diseases were selected as the study objects, and a binary logistic regression model was constructed according to the five dimensions of the health ecology model. The neural network model was used to explore the main (first two) factors affecting the increase in the number of chronic diseases in China in the short term, and the random forest and extreme value gradient lifting algorithm were used to verify them, and effective suggestions were put forward. RESULTS The detection rate of depression in the population with increasing number of chronic diseases from 2015 to 2018 was 42.13 %. The model was established based on five dimensions of the health ecology model: Model 1 (Personal trait layer), Model 2 (Personal trait layer plus Behavioral feature layer), Model 3 (Personal trait layer plus Behavioral feature layer plus Living and working conditions layer), Model 4 (Personal trait layer plus Behavioral feature layer plus Living and working conditions layer plus Networking layer) and Model 5 (Personal trait layer plus Behavioral feature layer plus Living and working conditions layer plus Networking layer plus Policy environment layer).The prediction accuracy of the five models was 66.4 %, 68.3 %, 70.7 %, 71.6 % and 71.6 %, respectively, and Model 5 showed that the P values of gender, self-rated health, night's sleep time (h), disability, life satisfaction, child satisfaction, place of residence and highest level of education were all <0.05, life satisfaction and self-rated health importance were 0.249 (100 %) and 0.226 (90.8 %). CONCLUSION Gender, self-rated health, night sleep duration, disability, satisfaction with life, satisfaction with children, place of residence and highest level of education were the main influencing factors for the increase of depressive symptoms in the population with chronic diseases in the short term, among which life satisfaction and self-rated health have the greatest impact on depressive symptoms, and there is an interaction between the two.
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Affiliation(s)
- Weimin Guan
- School of Public Health, Shandong Second Medical University, 7166# Baotong West Street, Weifang, Shandong 261053, China
| | - Wenyu Su
- School of Public Health, Shandong Second Medical University, 7166# Baotong West Street, Weifang, Shandong 261053, China
| | - Huaiju Ge
- School of Public Health, Shandong Second Medical University, 7166# Baotong West Street, Weifang, Shandong 261053, China
| | - Shihong Dong
- School of Public Health, Shandong Second Medical University, 7166# Baotong West Street, Weifang, Shandong 261053, China
| | - Huiyu Jia
- School of Public Health, Shandong Second Medical University, 7166# Baotong West Street, Weifang, Shandong 261053, China
| | - Yan Liu
- School of Public Health, Shandong Second Medical University, 7166# Baotong West Street, Weifang, Shandong 261053, China
| | - Qing Yu
- School of Public Health, Shandong Second Medical University, 7166# Baotong West Street, Weifang, Shandong 261053, China
| | - Yuantao Qi
- Shandong Cancer Research Institute (Shandong Tumor Hospital), Jinan, Shandong 250117, China
| | - Huiqing Zhang
- The First Affiliated Hospital of Shandong Second Medical University (Weifang People's Hospital), Weifang, Shandong 261000, China
| | - Guifeng Ma
- School of Public Health, Shandong Second Medical University, 7166# Baotong West Street, Weifang, Shandong 261053, China.
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Cohen KA, Ito S, Ahuvia IL, Yang Y, Zhang Y, Renshaw TL, Larson M, Cook C, Hill S, Liao J, Rapoport A, Smock A, Yang M, Schleider JL. Brief School-Based Interventions Targeting Student Mental Health or Well-Being: A Systematic Review and Meta-Analysis. Clin Child Fam Psychol Rev 2024; 27:732-806. [PMID: 38884838 DOI: 10.1007/s10567-024-00487-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2024] [Indexed: 06/18/2024]
Abstract
Brief, school-based mental health interventions hold promise for reducing barriers to mental health support access, a critical endeavor in light of increasing rates of mental health concerns among youth. However, there is no consensus on whether or not brief school-based interventions are effective at reducing mental health concerns or improving well-being. This systematic review and meta-analysis aims to provide consensus and determine directions for future work. Articles were included if they examined a brief (≤ four sessions or 240 min of intervention time) psychosocial intervention, were conducted within a Pre-K through 12th-grade school setting, included at least one treatment outcome evaluating mental health or well-being, and were published since 2000. A total of 6,702 papers were identified through database searching, of which 81 papers (k studies = 75) were ultimately selected for inclusion. A total of 40,498 students were included across studies and a total of 75 unique interventions were examined. A total of 324 effect sizes were extracted. On average, interventions led to statistically significant improvements in mental health/well-being outcomes versus control conditions up to one-month (g = .18, p = .004), six-month (g = .15, p = .006), and one-year (g = .10, p = .03) post-intervention. There may be benefits to brief school-based interventions from a preventative public health standpoint; future research may focus on how to optimize their real-world utility. Prospero pre-registration: CRD42021255079.
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Affiliation(s)
- Katherine A Cohen
- Department of Medical Social Sciences, Northwestern University, 625 N Michigan Ave, Chicago, IL, 60611, USA
| | - Sakura Ito
- Department of Psychology, Stony Brook University, Stony Brook, USA
| | - Isaac L Ahuvia
- Department of Psychology, Stony Brook University, Stony Brook, USA
| | | | - Yanchen Zhang
- Department of Psychological and Quantitative Foundations, University of Iowa, Iowa, USA
| | | | | | | | - Shannon Hill
- Department of Medical Social Sciences, Northwestern University, 625 N Michigan Ave, Chicago, IL, 60611, USA
| | - Jessica Liao
- Department of Medical Social Sciences, Northwestern University, 625 N Michigan Ave, Chicago, IL, 60611, USA
| | - Andy Rapoport
- Department of Medical Social Sciences, Northwestern University, 625 N Michigan Ave, Chicago, IL, 60611, USA
| | - Amanda Smock
- Department of Medical Social Sciences, Northwestern University, 625 N Michigan Ave, Chicago, IL, 60611, USA
| | - Michelle Yang
- Department of Medical Social Sciences, Northwestern University, 625 N Michigan Ave, Chicago, IL, 60611, USA
| | - Jessica L Schleider
- Department of Medical Social Sciences, Northwestern University, 625 N Michigan Ave, Chicago, IL, 60611, USA.
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Gattario KH, Vira EG, Lunde C, Skoog T. Peer sexual harassment, appearance esteem, and emotional problems: Testing a mediation model across early adolescence. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2024; 34:679-692. [PMID: 38486442 DOI: 10.1111/jora.12930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 02/22/2024] [Accepted: 02/28/2024] [Indexed: 08/28/2024]
Abstract
This study used a longitudinal sample of early adolescent boys and girls (ages 10-12; N = 1113) to test a theoretically and empirically informed model suggesting that exposure to peer sexual harassment (age 10) predicts more emotional problems (age 12), and that lower appearance esteem (age 11) mediates this relation. On the within-person level, which is the level on which the processes theoretically should play out, we found no support for the proposed mediation model for boys or for girls. Unexpectedly, we found that following times of more exposure to peer sexual harassment than usual, early adolescents instead experienced higher appearance esteem and fewer emotional problems than usual. More research is needed to replicate and understand these unexpected findings.
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Affiliation(s)
| | - Emily G Vira
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
| | - Carolina Lunde
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden
| | - Therése Skoog
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden
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Craddock N, Budhraja M, Garbett KM, Nasution K, Gentili C, Rizkiah C, Haime Z, Ayu Saraswati L, Medise BE, White P, Diedrichs PC, Williamson H. Evaluating a school-based body image lesson in Indonesia: A randomised controlled trial. Body Image 2024; 48:101654. [PMID: 38056068 DOI: 10.1016/j.bodyim.2023.101654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 11/08/2023] [Accepted: 11/20/2023] [Indexed: 12/08/2023]
Abstract
Negative body image is a common public health concern among adolescents, globally. The aim of the current study was to evaluate the effectiveness, implementation fidelity, and acceptability of a single session, school-based universal body image intervention in Indonesia. A total of 1926 adolescents (59.4 % girls) and 12 school guidance counsellors (lesson facilitators) from nine state junior secondary schools in Surabaya, East Java took part in a two-arm open parallel cluster randomised controlled trial. In response to the changing circumstances due to the COVID-19 pandemic, half of the lessons were conducted in person and half were delivered online. Results showed that the lesson did not significantly improve adolescent body image or secondary outcomes relative to the control, though there was no evidence of harm. There were no substantive findings regarding intervention effectiveness by gender. The mode of intervention delivery (online vs. in-person) did not significantly influence the main findings. Implementation fidelity varied widely, and the lesson content and pedagogy were largely acceptable, though there was a strong preference for in-person lesson delivery. Findings have implications for researchers aiming to improve adolescent body image in low- and middle-income countries. Lessons learned can inform future school-based efforts to support adolescent body image.
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Affiliation(s)
- Nadia Craddock
- Centre for Appearance Research, University of the West of England, Bristol, BS16 1QY, UK.
| | - Mahira Budhraja
- Centre for Appearance Research, University of the West of England, Bristol, BS16 1QY, UK
| | - Kirsty M Garbett
- Centre for Appearance Research, University of the West of England, Bristol, BS16 1QY, UK
| | | | - Caterina Gentili
- Centre for Appearance Research, University of the West of England, Bristol, BS16 1QY, UK
| | | | - Zoë Haime
- Population Health Sciences, Medical School, University of Bristol, UK
| | - L Ayu Saraswati
- University of Hawai`i, Manoa, Department of Women, Gender and Sexuality Studies, Honolulu, HI 96822, USA
| | | | - Paul White
- University of the West of England, Bristol BS16 1QY, UK
| | - Phillippa C Diedrichs
- Centre for Appearance Research, University of the West of England, Bristol, BS16 1QY, UK
| | - Heidi Williamson
- Centre for Appearance Research, University of the West of England, Bristol, BS16 1QY, UK
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Blundell E, De Stavola BL, Kellock MD, Kelly Y, Lewis G, McMunn A, Nicholls D, Patalay P, Solmi F. Longitudinal pathways between childhood BMI, body dissatisfaction, and adolescent depression: an observational study using the UK Millenium Cohort Study. Lancet Psychiatry 2024; 11:47-55. [PMID: 38101872 PMCID: PMC11139652 DOI: 10.1016/s2215-0366(23)00365-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 09/27/2023] [Accepted: 10/19/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND Globally, more adolescents are having depressive symptoms than in the past. High BMI is a risk factor for depressive symptoms, potentially acting via increased body dissatisfaction. Robust longitudinal evidence of these associations could help to inform preventive interventions, but such evidence remains scarce. We investigated the longitudinal associations between BMI at age 7 years and depressive symptoms at age 14 years (objective 1), BMI at age 7 years and body dissatisfaction at age 11 years (objective 2), and body dissatisfaction at age 11 years and depression at age 14 years (objective 3). We also investigated the extent to which body dissatisfaction mediated the association between BMI and depressive symptoms (objective 4). METHODS This study used data from the Millennium Cohort Study, a representative longitudinal general population cohort of UK children born between Sept 1, 2000, and Jan 11, 2002. We used univariable and multivariable linear regression models to investigate the associations in objectives 1-3 adjusting for a range of child-level and family-level confounders. For mediation analyses we used non-parametric g-formula (objective 4). We reported stratified results in presence of sex differences. All analyses were based on participants with complete BMI data and imputed confounders and outcomes. FINDINGS Our sample included 13 135 participants. Of these, 6624 (50·4%) were male participants and 6511 (49·6%) were female participants; 11 096 (84·4%) were of White ethnicity and 2039 (15·6%) were from a minority ethnic background. At baseline, mean age was 7·2 years (SD 0·25, range 6·3-8·3). In multivariable models, an SD increase in BMI at age 7 years was associated with greater depressive symptoms at age 14 years (estimated regression coefficient [coeff]: 0·30, 95% CI 0·17-0·43) and greater body dissatisfaction at age 11 years (coeff 0·15, 0·12-0·18). Greater body dissatisfaction at age 11 years was associated with higher depressive symptoms at age 14 years (coeff 0·60, 0·52-0·68). All these associations were twice as large in girls as in boys. Body dissatisfaction explained 43% of the association between BMI and depression in girls. INTERPRETATION Our findings bear relevance for interventions aimed at reducing weight in childhood and reducing body dissatisfaction. Implementation of evidence-based body image interventions and identification of drivers of weight stigma should be key public health priorities. Interventions aiming to reduce weight in childhood need to avoid increasing body dissatisfaction and should target environmental drivers of weight rather than individuals. FUNDING Wellcome Trust; The Royal Society; Economic and Social Research Council; and the National Institute for Health and Care Research.
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Affiliation(s)
- Emma Blundell
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | | | | | - Yvonne Kelly
- Institute of Epidemiology & Health, University College London, London, UK
| | - Gemma Lewis
- Division of Psychiatry, University College London, London, UK
| | - Anne McMunn
- Institute of Epidemiology & Health, University College London, London, UK
| | - Dasha Nicholls
- Division of Psychiatry, Imperial College London, London, UK
| | - Praveetha Patalay
- Centre for Longitudinal Studies and MRC Unit for Lifelong Health & Ageing, University College London, London, UK
| | - Francesca Solmi
- Division of Psychiatry, University College London, London, UK.
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Inns SJ, Chen A, Myint H, Lilic P, Ovenden C, Su HY, Hall RM. Comparative Analysis of Body Image Dissatisfaction, Depression, and Health-Related Quality of Life in Adults with Type 1 Diabetes: A Case-Control Study. Nutrients 2023; 15:3938. [PMID: 37764722 PMCID: PMC10534710 DOI: 10.3390/nu15183938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/08/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
(1) Objective: This case-control study investigated body image dissatisfaction, depression, and health-related quality of life (HRQoL) in adults with type 1 diabetes. (2) Methods: A total of 35 adults with diabetes and an equal number of age- and gender-matched controls were included. Assessment tools used were the Body Image Disturbance Questionnaire (BIDQ), the Hospital Anxiety and Depression Scale (HADS), and the RAND 36-Item Health Survey. Both quantitative and qualitative data were analyzed. (3) Results: Body image dissatisfaction did not differ significantly between the groups. However, adults with diabetes reported higher levels of depression (p = 0.002) and lower scores for physical health (p = 0.015) and general health (p < 0.001) on the HRQoL measure. Qualitative analysis identified common themes related to physical disturbance, effect on activities, and psychosocial concerns. (4) Conclusions: Despite similar body image dissatisfaction, adults with type 1 diabetes exhibited increased depression and reduced HRQoL. These findings emphasize the need to integrate psychological well-being into type 1 diabetes management. They also support further research into the impact of body image dissatisfaction in T1D and potential interventions to address it.
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Affiliation(s)
- Stephen J. Inns
- Te Whatu Ora Health New Zealand, P.O. Box 793, Wellington 6140, New Zealand (C.O.)
- Department of Medicine, University of Otago, P.O. Box 7343, Wellington 6242, New Zealand
| | - Amanda Chen
- Te Whatu Ora Health New Zealand, P.O. Box 793, Wellington 6140, New Zealand (C.O.)
| | - Helen Myint
- Te Whatu Ora Health New Zealand, P.O. Box 793, Wellington 6140, New Zealand (C.O.)
| | - Priyanka Lilic
- Te Whatu Ora Health New Zealand, P.O. Box 793, Wellington 6140, New Zealand (C.O.)
| | - Crispin Ovenden
- Te Whatu Ora Health New Zealand, P.O. Box 793, Wellington 6140, New Zealand (C.O.)
| | - Heidi Y. Su
- Te Whatu Ora Health New Zealand, P.O. Box 793, Wellington 6140, New Zealand (C.O.)
| | - Rosemary M. Hall
- Te Whatu Ora Health New Zealand, P.O. Box 793, Wellington 6140, New Zealand (C.O.)
- Department of Medicine, University of Otago, P.O. Box 7343, Wellington 6242, New Zealand
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Smith AC, Ahuvia I, Ito S, Schleider JL. Project Body Neutrality: Piloting a digital single-session intervention for adolescent body image and depression. Int J Eat Disord 2023; 56:1554-1569. [PMID: 37129116 PMCID: PMC10524309 DOI: 10.1002/eat.23976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 04/17/2023] [Accepted: 04/17/2023] [Indexed: 05/03/2023]
Abstract
OBJECTIVE Eating disorders and depression impact youth at alarming rates, yet most adolescents do not access support. Single-session interventions (SSIs) can reach youth in need. This pilot examines the acceptability and utility of a SSI designed to help adolescents improve functionality appreciation (a component of body neutrality) by focusing on valuing one's body based on the functions it performs, regardless of appearance satisfaction. METHOD Pre- to post-intervention data were collected, and within-group effect sizes and 95% confidence intervals were computed, to evaluate the immediate effects of the SSI on hopelessness, functionality appreciation, and body dissatisfaction. Patterns of use, demographics, program feedback, and responses from within the SSI were collected. RESULTS The SSI and all questionnaires were completed by 75 adolescents (ages: 13-17 years, 74.70% White/Caucasian, 48.00% woman/girl) who reported elevated body image and mood problems. Analyses detected significant pre-post improvements in hopelessness (dav = 0.60, 95% CI: 0.35-0.84; dz = 0.77, 95% CI: 0.51-1.02), functionality appreciation (dav = 0.72, 95% CI: 0.46-0.97; dz = 0.94, 95% CI: 0.67-1.21), and body dissatisfaction (dav = 0.61, 95% CI: 0.36-0.86; dz = 0.76, 95% CI: 0.50-1.02). The SSI was rated as highly acceptable, with a mean overall score of 4.34/5 (SD = 0.54). Qualitative feedback suggested adolescents' endorsement of body neutrality concepts, including functionality appreciation, as personally-relevant, helpful targets for intervention. DISCUSSION This evaluation supports the acceptability and preliminary effectiveness of the Project Body Neutrality SSI for adolescents with body image and mood concerns. PUBLIC SIGNIFICANCE Results suggest the acceptability and utility of a digital, self-guided, single-session intervention-Project Body Neutrality-for adolescents experiencing co-occurring depressive symptoms and body image disturbances. Given the intervention's low cost and inherent scalability, it may be positioned to provide support to youth with limited access to traditional care.
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Affiliation(s)
- Arielle C Smith
- Department of Psychology, Stony Brook University, Stony Brook, New York, USA
| | - Isaac Ahuvia
- Department of Psychology, Stony Brook University, Stony Brook, New York, USA
| | - Sakura Ito
- Department of Psychology, Stony Brook University, Stony Brook, New York, USA
| | - Jessica L Schleider
- Department of Psychology, Stony Brook University, Stony Brook, New York, USA
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
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Osborne EL, Ainsworth B, Chadwick P, Atkinson MJ. The role of emotion regulation in the relationship between mindfulness and risk factors for disordered eating: A longitudinal mediation analysis. Int J Eat Disord 2023; 56:458-463. [PMID: 36367130 PMCID: PMC10099542 DOI: 10.1002/eat.23849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 10/27/2022] [Accepted: 10/28/2022] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Evidence suggests mindfulness may reduce risk factors for disordered eating. However, mechanisms of change in this relationship are unclear. This longitudinal study tested whether emotion regulation mediates the prospective associations between mindfulness and two proximal risk factors for disordered eating: weight and shape concerns, and negative affect. METHOD This study is a secondary analysis of data collected within an eating disorder prevention trial. Adolescent girls (N = 374, Mage = 15.70, SD = 0.77) completed self-report measures of mindfulness, emotion regulation, weight and shape concerns, and negative affect at baseline, 2 months following baseline, and 7 months following baseline. Path analyses were computed to test hypothesized indirect effects using confidence intervals based on 5000 bootstrap samples. RESULTS Higher baseline mindfulness predicted lower weight and shape concerns and negative affect at 7 months via a mediator of better emotion regulation at 2 months. This effect remained while controlling for earlier measurements of the mediator and outcome in the model of negative affect but not weight and shape concerns. DISCUSSION Emotion regulation may be an important mechanism explaining how mindfulness influences negative affect. Efforts should be made to intervene on mindfulness and emotion regulation in prevention and early intervention programmes for eating disorders and other psychiatric conditions. PUBLIC SIGNIFICANCE Research has shown that mindfulness can help to reduce some of the risk of developing an eating disorder. This study explored whether mindfulness reduces some of this risk by helping people to better manage their emotions. Understanding this process can help us to develop better mindfulness-based strategies to support people who are at risk of developing an eating disorder.
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Affiliation(s)
| | - Ben Ainsworth
- Department of Psychology, University of Bath, Bath, UK.,School of Psychology, University of Southampton, Southampton, UK
| | - Paul Chadwick
- Department of Psychology, University of Bath, Bath, UK
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