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Coelho JS, Pardiwala T, Marshall SK, Lam PY, Grewal S, Virani A, Olmos Pérez A, Geller J. Clinical care for severe and persistent eating disorders in pediatric populations: Perspectives of health professionals. J Eat Disord 2024; 12:83. [PMID: 38886837 PMCID: PMC11181587 DOI: 10.1186/s40337-024-01044-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 06/10/2024] [Indexed: 06/20/2024] Open
Abstract
OBJECTIVE Models of treatment for adults with severe and enduring eating disorders focus on harm reduction and improving quality of life. However, there is a notable gap in the pediatric literature in this area. The current study set out to assess the perspectives of health professionals regarding clinical care for young people (e.g., ages 10-25 years) with severe and enduring eating disorders, and to explore perceptions about appropriate treatment options for these presentations. METHODS Health professionals were invited to complete a two-stage online survey about their experiences with clinical care for pediatric eating disorders through Canadian and Australian professional eating disorder networks. Survey 1 included questions about their experiences in supporting individuals with severe and enduring presentations. Participants who completed Survey 2 reviewed clinical vignettes and shared their perspectives about treatment recommendations and models of care, including for a severe and enduring presentation. RESULTS A total of 85 clinicians responded to questions on Survey 1 about severe and enduring eating disorder presentations. A portion of these respondents (n = 25) also participated in Survey 2. The majority of respondents to Survey 1 reported providing clinical care for pediatric severe and enduring eating disorder presentations. Amongst respondents to Survey 2, there was low consensus amongst respondents for the clinical care that would be most appropriate for young people with a severe and enduring eating disorder presentation. Numerous challenges in models of care for severe and enduring presentations in pediatric settings were raised in responses on Survey 2, with clinicians sharing their awareness of models focusing on quality of life, while also raising concerns about the appropriateness of these models for young people. CONCLUSIONS The preliminary results of this study demonstrate that the majority of clinicians report that they have provided care to young people with severe and enduring presentations. There is a clear need for establishing guidance for clinicians working in pediatric eating disorder settings around models of care focused on quality of life. Engagement with interested parties, including those with lived experience, can clarify the development of terminology and clinical pathways for severe and enduring presentations of pediatric eating disorders.
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Affiliation(s)
- Jennifer S Coelho
- Provincial Specialized Eating Disorders Program for Children and Adolescents, BC Children's Hospital, 4500 Oak St., Box 150, Vancouver, BC, V6H3N1, Canada.
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.
| | - Tanya Pardiwala
- Provincial Specialized Eating Disorders Program for Children and Adolescents, BC Children's Hospital, 4500 Oak St., Box 150, Vancouver, BC, V6H3N1, Canada
| | - Sheila K Marshall
- School of Social Work, University of British Columbia, Vancouver, BC, Canada
| | - Pei-Yoong Lam
- Provincial Specialized Eating Disorders Program for Children and Adolescents, BC Children's Hospital, 4500 Oak St., Box 150, Vancouver, BC, V6H3N1, Canada
- Division of Adolescent Health and Medicine, Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Seena Grewal
- Provincial Specialized Eating Disorders Program for Children and Adolescents, BC Children's Hospital, 4500 Oak St., Box 150, Vancouver, BC, V6H3N1, Canada
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Alice Virani
- Provincial Health Services Authority Ethics Service, Vancouver, BC, Canada
| | | | - Josie Geller
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
- Provincial Adult Tertiary and Specialized Eating Disorders Program, St. Paul's Hospital, Vancouver, BC, Canada
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Healy DR, Mansson N, Furu M, Bratlandsanda S, Sjögren JM. Maximal Resistance Training in the Treatment of Anorexia Nervosa - A Case Report Series. INTERNATIONAL JOURNAL OF EXERCISE SCIENCE 2024; 17:308-326. [PMID: 38665689 PMCID: PMC11042857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Abstract
Objective Anorexia Nervosa (AN) has one of the highest mortality rates of all mental health disorders, low recovery rate and is associated with widespread endocrine dysfunction. Resistance training (RT) has been consistently shown to provide beneficial effects on health outcomes that are often negatively affected by AN, however participation in exercise is controversial for individuals with AN. The objective of this study was to assess the effects of maximal RT as an add-on to standard of care in patients with AN. Methods Originally, a controlled clinical trial was planned but due to COVID-19 pandemic, the study was prematurely ended and reported as a case series design. Three female inpatients with AN (Age 18-29 years, body mass index (BMI) 14.5-16.3 kg/m2, illness duration 1-7 years) underwent a supervised 6-week RT intervention as an add-on to standard of care. Primary outcome was muscular strength, as measured by a 1-repetition maximum. Secondary outcomes included BMI, eating disorder psychopathology and maladaptive exercise tendencies. Results No adverse events were reported. All three participants improved lower body muscle strength, ranging from 32% to 134% in the leg press. Changes of 4% to 134% in the bench press and -3% to 38% in the pulldown were also observed. Conclusions RT improved muscular strength in the participants. RT as part of standard of care may also provide additional benefits for individuals with AN, although further research is required to determine which subtype of patients would benefit from the addition of RT to their treatment protocol.
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Affiliation(s)
- Darren R Healy
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, DENMARK
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, FINLAND
| | - Nicole Mansson
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, DENMARK
| | - Mia Furu
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, DENMARK
| | - Solfrid Bratlandsanda
- Department of Sport, Physical Education, and Outdoor Sciences, University of South-Eastern Norway, Bø, NORWAY
| | - Jan Magnus Sjögren
- Research Unit of Eating Disorders, Psychiatric Center Ballerup, Ballerup, DENMARK
- Institute for Clinical Science and Psychiatry, Umeå University, Umeå, SWEDEN
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Kleszczewska-Albińska A. Potential applications of Schema Therapy in the treatment of adolescents with anorexia nervosa: a theoretical analysis. POSTEPY PSYCHIATRII NEUROLOGII 2023; 32:215-233. [PMID: 38559610 PMCID: PMC10976625 DOI: 10.5114/ppn.2023.135530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 12/19/2023] [Indexed: 04/04/2024]
Abstract
Purpose The main purpose of the article is to present basic theoretical assumptions on Schema Therapy and its hypothetical application among adolescents suffering with anorexia nervosa. Views Anorexia nervosa is a very deadly mental disease, more frequently suffered by females than males, with the mean age of onset at approximately 14-15. Studies underline the relatively poor effectiveness of currently applied treatment methods and the need for new approaches that could be recommended for adolescent patients suffering with this disease. The results of studies conducted to date lead to the conclusion that Schema Therapy is a promising approach for this group. It is a transdiagnostic method of work that compiles elements known in other therapeutic approaches, aiming at an increase in the individual's awareness of their feelings and emotional needs, applied both in adolescent and adult groups of patients. Since the symptoms of eating disorders observed in adolescents are strongly connected with family systems it seems reasonable to use treatment techniques that rigorously address the unmet needs and rejected emotions of the individual. Conclusions Based on the data published so far it might be hypothesized that the techniques characteristic for Schema Therapy (e.g. imagery rescripting, chairwork, limited reparenting) could be eligible for use with adolescent patients with anorexia nervosa.They address unmet needs, rejected emotions, and early maladaptive schemas that are very frequent in patients with AN. Since the analysis presented provides only hypotheses and the discussion of theoretical aspects, empirical research in this area is needed.
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van Dijk SDM, Veenstra MS, van den Brink RHS, van Alphen SPJ, Oude Voshaar RC. A Systematic Review of the Heterogeneity of Schema Therapy. J Pers Disord 2023; 37:233-262. [PMID: 37002933 DOI: 10.1521/pedi.2023.37.2.262] [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] [Indexed: 04/04/2023]
Abstract
We aimed to explore the heterogeneity of schema therapy regarding (a) patient characteristics, (b) content, and (c) way of delivering schema therapy. A search was conducted of the electronic databases EMBASE, PsycINFO, Web of Science, MEDLINE, and COCHRANE up to June 15, 2022. Treatment studies were eligible if they (a) used schema therapy as (component of) the intervention examined, and (b) reported an outcome measure quantitatively. A total of 101 studies met the inclusion criteria, including randomized controlled trials (n = 30), non-randomized controlled trials (n = 8), pre-post designs (n = 22), cases series (n = 13), and case reports (n = 28), including 4006 patients. Good feasibility was consistently reported irrespective of format (group versus individual), setting (outpatient, day-treatment, inpatient), intensity of treatment, and the specific therapeutic components included. Schema therapy was applied to various (psychiatric) disorders. All studies presented promising results. Effectiveness of the different models of schema therapy as well as application beyond personality disorders should be examined more rigorously.
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Affiliation(s)
- Silvia D M van Dijk
- University Centre of Psychiatry, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
| | - Martine S Veenstra
- University Centre of Psychiatry, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
| | - Rob H S van den Brink
- University Centre of Psychiatry, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
| | - Sebastiaan P J van Alphen
- Department of Clinical & Life Span Psychology, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Department of Medical & Clinical Psychology, Tilburg University, Tilburg, the Netherlands
| | - Richard C Oude Voshaar
- University Centre of Psychiatry, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
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Sfeir M, Rahme C, Obeid S, Hallit S. The mediating role of anxiety and depression between problematic social media use and bulimia nervosa among Lebanese university students. J Eat Disord 2023; 11:52. [PMID: 36991483 PMCID: PMC10052263 DOI: 10.1186/s40337-023-00776-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 03/20/2023] [Indexed: 03/30/2023] Open
Abstract
Background Bulimia nervosa (BN) is a disorder that is characterized by binge eating and inappropriate compensatory behavior to control weight. The aim of this study was to evaluate the mediating role of anxiety and depression between problematic social media use (PSMU) and BN among a sample of Lebanese university students. Methods This cross-sectional study was carried out between July and September 2021; a total of 363 university students was recruited through convenience sampling. The PROCESS SPSS Macro version 3.4, model four was used to test the indirect effect and calculate three pathways. Pathway A determined the regression coefficient for the effect of PSMU on mental health issues (depression/anxiety); Pathway B examined the association between mental health issues on BN, and Pathway C’ estimated the direct effect of PSMU on BN. Pathway AB was used to calculate the indirect effect of PSMU on BN via depression/anxiety. Results Results showed that depression and anxiety partially mediated the association between PSMU and BN. Higher levels of PSMU were associated with more depression and anxiety; higher depression and anxiety were associated with more BN. PSMU was directly and significantly associated with more BN. When entering anxiety (M1) then depression (M2) as consecutive mediators in a first model, the results showed that only depression mediated the association between PSMU and bulimia. When taking depression (M1) then anxiety (M2) as consecutive mediators in a second model, the results showed that the mediation PSMU → Depression → Anxiety → Bulimia was significant. Higher PSMU was significantly associated with more depression, which was significantly associated with more anxiety, which was significantly associated with more bulimia. Finally, higher PSMU was directly and significantly associated with more bulimia Conclusion The current paper highlights the relationship that social media use has on BN and other aspects of mental health such as anxiety and depression in Lebanon. Future studies should replicate the mediation analysis conducted in the current study while taking into account other eating disorders. Additional investigations of BN and its correlates must strive to improve the comprehension of these associations’ pathways through designs that allow to draw temporal frameworks, in order to efficiently treat this eating disorder and prevent its negative outcomes. Bulimia nervosa, an eating disorder, is characterized by an impulsive consumption of food in a short period of time, followed by behaviors that compensate the eating such as vomiting or excessive exercise in order to avoid weight gain. Individuals with problematic social media use were found to have higher levels of bulimia symptoms. Symptoms of bulimia can also be associated with both depression and anxiety. The aim of the current study was to examine the mediating role of anxiety and depression between problematic social media use and bulimia nervosa. The results of our study found that problematic social media use was directly associated with more bulimia nervosa and also associated with higher depression and anxiety, both of which were associated with bulimia nervosa. Tackling associated disorders may help reduce symptoms of bulimia nervosa. Clinicians should carefully examine these associations while assessing and implementing treatment plans.
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Affiliation(s)
- Michel Sfeir
- grid.8364.90000 0001 2184 581XDepartment of Clinical Psychology, University of Mons, Mons, Belgium
- grid.9851.50000 0001 2165 4204Institute of Psychology (IP), Faculty of Social and Political Sciences, University of Lausanne, Lausanne, Switzerland
| | - Clara Rahme
- grid.512933.f0000 0004 0451 7867Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
| | - Sahar Obeid
- grid.411323.60000 0001 2324 5973Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon
| | - Souheil Hallit
- grid.512933.f0000 0004 0451 7867Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
- grid.444434.70000 0001 2106 3658School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
- grid.411423.10000 0004 0622 534XApplied Science Research Center, Applied Science Private University, Amman, Jordan
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Stalias-Mantzikos ME, Barahmand U, Aguero K, Peters L, Shamsina N. Early maladaptive schemas in misophonia. CLIN PSYCHOL-UK 2023. [DOI: 10.1080/13284207.2023.2171786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2023]
Affiliation(s)
- Maria E. Stalias-Mantzikos
- Department of Psychology, City University of New York, Queens College, New York, NY, USA
- Westchester Community College, SUNY, New York, NY, USA
| | - Usha Barahmand
- Department of Psychology, City University of New York, Queens College, New York, NY, USA
| | - Kerry Aguero
- Department of Psychology, City University of New York, Queens College, New York, NY, USA
| | - Laurisa Peters
- Department of Psychology, City University of New York, Queens College, New York, NY, USA
| | - Naila Shamsina
- Department of Psychology, City University of New York, Queens College, New York, NY, USA
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Wons O, Lampe E, Patarinski AG, Schaumberg K, Butryn M, Juarascio A. Perceived influence of wearable fitness trackers on eating disorder symptoms in a clinical transdiagnostic binge eating and restrictive eating sample. Eat Weight Disord 2022; 27:3367-3377. [PMID: 36006603 PMCID: PMC9403232 DOI: 10.1007/s40519-022-01466-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 07/31/2022] [Indexed: 01/06/2023] Open
Abstract
Wearable fitness trackers are an increasingly popular tool for measuring physical activity (PA) due their accuracy and momentary data collection abilities. Despite the benefits of using wearable fitness trackers, there is limited research in the eating disorder (ED) field using wearable fitness trackers to measure PA in the context of EDs. Wearable fitness trackers are often underused in ED research because there is limited knowledge about whether wearable fitness trackers negatively or positively impact PA engagement and ED symptoms in individuals with EDs. The current study aimed to assess the perceived impact wearable fitness trackers have on PA engagement and ED symptoms over a 12-week CBT treatment for 30 individuals with binge eating and restrictive eating that presented to treatment engaging or not engaging in maladaptive exercise. Participants in the maladaptive exercise group (n = 17) and non-maladaptive exercise group (n = 13) wore a fitness tracker for 12 weeks and completed questionnaires assessing participants' perceptions of the fitness trackers' influence on ED symptoms and PA engagement throughout treatment. Results demonstrated a small percentage of individuals perceived the fitness tracker influenced ED behaviors or PA engagement, and there were mixed results on whether participants positively or negatively perceived the fitness tracker influenced them to engage in ED behaviors or PA engagement. Although preliminary, these results demonstrate the need to continue using objective measurements of PA via wearable fitness trackers to further our understanding of the positive and negative effects of fitness trackers on clinical ED samples.Level of Evidence: Level 1, randomized controlled trial.
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Affiliation(s)
- Olivia Wons
- Department of Psychological and Brain Sciences, Drexel University, Stratton Hall, 3141 Chestnut Street, Philadelphia, PA, 19104, USA.
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Stratton Hall, 3141 Chestnut Street, Philadelphia, PA, 19104, USA.
| | - Elizabeth Lampe
- Department of Psychological and Brain Sciences, Drexel University, Stratton Hall, 3141 Chestnut Street, Philadelphia, PA, 19104, USA
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Stratton Hall, 3141 Chestnut Street, Philadelphia, PA, 19104, USA
| | - Anna Gabrielle Patarinski
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Stratton Hall, 3141 Chestnut Street, Philadelphia, PA, 19104, USA
| | - Katherine Schaumberg
- Department of Psychiatry, University of Wisconsin-Madison, 6001 Research Park Blvd, Madison, WI, 53719, USA
| | - Meghan Butryn
- Department of Psychological and Brain Sciences, Drexel University, Stratton Hall, 3141 Chestnut Street, Philadelphia, PA, 19104, USA
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Stratton Hall, 3141 Chestnut Street, Philadelphia, PA, 19104, USA
| | - Adrienne Juarascio
- Department of Psychological and Brain Sciences, Drexel University, Stratton Hall, 3141 Chestnut Street, Philadelphia, PA, 19104, USA
- Center for Weight, Eating, and Lifestyle Science, Drexel University, Stratton Hall, 3141 Chestnut Street, Philadelphia, PA, 19104, USA
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Yakın E, Obeid S, Fekih-Romdhane F, Soufia M, Sawma T, Samaha S, Mhanna M, Azzi R, Mina A, Hallit S. "In-between orthorexia" profile: the co-occurrence of pathological and healthy orthorexia among male and female non-clinical adolescents. J Eat Disord 2022; 10:155. [PMID: 36329509 PMCID: PMC9633027 DOI: 10.1186/s40337-022-00673-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 10/10/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND The profile of adolescents with orthorexic eating behaviors remains to be explored. This study is the first to explore the typology of Lebanese adolescents from a large non-clinical sample based on orthorexia nervosa (ON) and healthy orthorexia (HO). METHOD A total of 555 adolescents (aged between 15 and 18 years) completed a set of questionnaires assessing orthorexic behaviors, self-esteem, stress, depressive and anxiety symptoms. Cluster analysis based on ON and HO scores was used to identify the typology of the sample. More precisely, this analysis was used to reveal and distinguish between naturally occurring subgroups of individuals with different orthorexic eating profiles, within the studied sample. Further, a series of one-way ANOVA was used to compare observed clusters based on their scores on used questionnaires. This analysis was used to capture the behavioral and psychological differences between previously yielded subgroups of individuals. RESULTS Cluster analysis based on ON and HO scores yielded 3 distinct groups: "Low orthorexia", "Moderate in-between orthorexia" and "High in-between orthorexia". While the first group represented individuals with no particular (healthy or pathological) interest in healthy eating, the two latter groups represented those with respectively moderate and high degrees of an interest in healthy eating that has both pathological and healthy aspects. Significant differences between clusters regarding their levels of stress, depression, anxiety and self-esteem was observed, yet they were found to be negligible due to poor effect sizes. CONCLUSION Findings from this study suggest that ON and HO can indeed co-occur among adolescents, that this co-occurrence can be experienced at different severity levels. Low effect sizes for ANOVA comparisons may suggest the possibility of the co-occurrence of ON and HO reducing the negative effects of ON behavior to some degree. The potential role of confusion around what constitutes "healthy eating" in the emergence of these "in-between orthorexia" profiles is put forward.
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Affiliation(s)
- Ecem Yakın
- Centre d'Études et de Recherches en Psychopathologie et Psychologie de la Santé, Université de Toulouse-Jean Jaurès, UT2J, 5 allées Antonio Machado, 31058, Toulouse, France
| | - Sahar Obeid
- Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon
| | - Feten Fekih-Romdhane
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry "Ibn Omrane", Razi Hospital, 2010, Manouba, Tunisia.,Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Michel Soufia
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Toni Sawma
- Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon
| | - Serena Samaha
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Mariam Mhanna
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Reine Azzi
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Anthony Mina
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon. .,Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.
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Spivak O, Konichezky A. Schema focused and mentalization based therapy – An integrative proposal. EUROPEAN JOURNAL OF PSYCHOTHERAPY & COUNSELLING 2022. [DOI: 10.1080/13642537.2022.2072928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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10
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Sasanfar B, Toorang F, Rostami S, Yeganeh MZ, Ghazi ML, Seyyedsalehi MS, Zendehdel K. The effect of nutrition education for cancer prevention based on health belief model on nutrition knowledge, attitude, and practice of Iranian women. BMC Womens Health 2022; 22:213. [PMID: 35672814 PMCID: PMC9175379 DOI: 10.1186/s12905-022-01802-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 05/27/2022] [Indexed: 11/10/2022] Open
Abstract
Background In recent years, nutrition has received an increasingly important role in the etiology of cancer. Thus, public education about dietary factors associated with cancer risk or prevention could be an important intervention for cancer prevention, particularly in low- and middle-income countries where the burden of cancer is increasing rapidly and the access to care is limited. The age-standardized incidence of breast cancer was 35.8 among Iranian women in 2020. We aimed to study the effect of nutrition education on the knowledge, attitude, and practice of Iranian women towards dietary factors related to cancer.
Methods In this interventional study, 229 women from public health centers were recruited and underwent three 75-min sessions of education based on the Health Belief Model (HBM). Participants were interviewed by trained interviewers using a validated and reproducible nutrition-related cancer prevention knowledge, attitude, and practice questionnaire (NUTCANKAP) questionnaire designed based on the HBM. Nutritional knowledge, attitude, and practice of participants were assessed through this questionnaire. Three 24-h dietary recalls (one weekend and two nonconsecutive weekdays) were also collected before and one month after the intervention. Results The mean age of the participants was 45.14 years, and the mean BMI was 27.2 kg/m2. After the intervention, the participants had a higher intake of whole grain (p = 0.03) and a lower fat dairy (p = 0.009) and nuts (p = 0.04). However, the intake of high-fat dairy (p = 0.001) decreased after the intervention. We indicated significant differences in knowledge (p < 0.001) and nutritional practice scores (p = 0.01) after education. In addition, after the intervention, there were significant differences in the mean score of the HBM components, except for the perceived self-efficacy. Conclusion Participation in a nutrition education program positively impacted the knowledge and nutritional practices linked to cancer prevention.
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Affiliation(s)
- Bahareh Sasanfar
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, P.O.Box: 13145158, Tehran, Iran
| | - Fatemeh Toorang
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, P.O.Box: 13145158, Tehran, Iran.,Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Sahar Rostami
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, P.O.Box: 13145158, Tehran, Iran
| | - Maryam Zarif Yeganeh
- Department of Community Nutrition Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Lafzi Ghazi
- Department of Exercise Physiology, Central Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Monireh Sadat Seyyedsalehi
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, P.O.Box: 13145158, Tehran, Iran.,Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Kazem Zendehdel
- Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, P.O.Box: 13145158, Tehran, Iran. .,Cancer Biology Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran. .,Breast Diseases Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran.
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Zolfaghari E, Armaghanian N, Waller D, Medlow S, Hobbs A, Perry L, Nguyen K, Steinbeck K. Implementation science in adolescent healthcare research: an integrative review. BMC Health Serv Res 2022; 22:598. [PMID: 35505305 PMCID: PMC9066920 DOI: 10.1186/s12913-022-07941-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 04/11/2022] [Indexed: 11/18/2022] Open
Abstract
Background Multiple theories, models and frameworks have been developed to assist implementation of evidence-based practice. However, to date there has been no review of implementation literature specific to adolescent healthcare. This integrative review therefore aimed to determine what implementation science theories, models and frameworks have been applied, what elements of these frameworks have been identified as influential in promoting the implementation and sustainability of service intervention, and to what extent, in what capacity and at what time points has the contribution of adolescent consumer perspectives on evidence implementation been considered. Methods An integrative design was used and reported based on a modified form of the PRISMA (2020) checklist. Seven databases were searched for English language primary research which included any implementation science theory, model or framework developed for/with adolescents or applied in relation to adolescent healthcare services within the past 10 years. Content and thematic analysis were applied with the Consolidated Framework for Implementation Research (CFIR) used to frame analysis of the barriers and facilitators to effective implementation of evidence-informed interventions within youth health settings. Results From 8717 citations, 13 papers reporting 12 studies were retained. Nine different implementation science theories, frameworks or approaches were applied; six of 12 studies used the CFIR, solely or with other models. All CFIR domains were represented as facilitators and barriers for implementation in included studies. However, there was little or no inclusion of adolescents in the development or review of these initiatives. Only three mentioned youth input, occurring in the pre-implementation or implementation stages. Conclusions The few studies found for this review highlight the internationally under-developed nature of this topic. Flagging the importance of the unique characteristics of this particular age group, and of the interventions and strategies to target it, the minimal input of adolescent consumers is cause for concern. Further research is clearly needed and must ensure that youth consumers are engaged from the start and consistently throughout; that their voice is prioritised and not tokenistic; that their contribution is taken seriously. Only then will age-appropriate evidence implementation enable innovations in youth health services to achieve the evidence-based outcomes they offer. Trial Registration PROSPERO 2020 CRD42020201142 https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=201142 Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07941-3.
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Affiliation(s)
- Elham Zolfaghari
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia.,Academic Department of Adolescent Medicine, The Children's Hospital Westmead, Westmead, NSW, 2145, Australia
| | - Natasha Armaghanian
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia. .,Academic Department of Adolescent Medicine, The Children's Hospital Westmead, Westmead, NSW, 2145, Australia.
| | - Daniel Waller
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia.,Academic Department of Adolescent Medicine, The Children's Hospital Westmead, Westmead, NSW, 2145, Australia.,Faculty of Health, University of Technology Sydney, Broadway, Ultimo, NSW, 2007, Australia
| | - Sharon Medlow
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia.,Academic Department of Adolescent Medicine, The Children's Hospital Westmead, Westmead, NSW, 2145, Australia
| | - Annabelle Hobbs
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia.,Academic Department of Adolescent Medicine, The Children's Hospital Westmead, Westmead, NSW, 2145, Australia
| | - Lin Perry
- Faculty of Health, University of Technology Sydney, Broadway, Ultimo, NSW, 2007, Australia.,South East Sydney Local Health District, Prince of Wales Hospital, Randwick, NSW, 2316, Australia
| | - Katie Nguyen
- Academic Department of Adolescent Medicine, The Children's Hospital Westmead, Westmead, NSW, 2145, Australia
| | - Katharine Steinbeck
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia.,Academic Department of Adolescent Medicine, The Children's Hospital Westmead, Westmead, NSW, 2145, Australia
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12
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Ganson KT, Lavender JM, Rodgers RF, Cunningham M, Nagata JM. Compulsive exercise and vaping among a sample of U.S. College students aged 18-26 years. Eat Weight Disord 2022; 27:1153-1161. [PMID: 34181209 DOI: 10.1007/s40519-021-01251-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 06/17/2021] [Indexed: 02/07/2023] Open
Abstract
PURPOSE To determine the association between compulsive exercise and vaping among college students aged 18-26 years, and to characterize the type of vaping used among participants who report compulsive exercise. METHODS Cross-sectional, pooled data from two survey years (2018-2020; N = 2125) of the national (U.S.) Healthy Minds Study were analyzed. Compulsive exercise was measured based on number of occurrences in the past 28 days (analyzed continuously and among those who reported ≥ 1 and ≥ 20 occurrences). Vaping was measured based on reported use in the past 30 days. Most recent type of vaping was assessed only among participants who reported vaping. Logistic regression analyses were conducted to estimate the associations between compulsive exercise and vaping, while adjusting for covariates. RESULTS For every additional occurrence of compulsive exercise reported by participants, their odds of also reporting vaping increased by 5% (95% CI 1.01-1.09). Participants who reported 20 or more occurrences of compulsive exercise in the past 28 days, a clinical threshold, had 3.71 (95% CI 1.28-10.76) higher odds of vaping in the past 30 days. Among participants who endorsed vaping, nicotine vaping was the most common recent type for those who reported any (76.2%) or 20 or more (50.2%) occurrences of compulsive exercise. CONCLUSION Compulsive exercise is associated with vaping in a national, U.S. sample of college students, with nicotine vaping being the most common type used. Screening for both compulsive exercise and vaping, particularly if either is reported, among college-age young adults is necessary to implement prevention and intervention strategies. LEVEL OF EVIDENCE V, cross-sectional descriptive study.
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Affiliation(s)
- Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Toronto, ON, M5S 1V4, Canada.
| | - Jason M Lavender
- Department of Medicine, Uniformed Services University, Bethesda, MD, USA.,Military Cardiovascular Outcomes Research (MiCOR) Program, Bethesda, MD, USA.,Metis Foundation, San Antonio, TX, USA
| | - Rachel F Rodgers
- Department of Applied Psychology, Northeastern University, Boston, MA, USA.,Department of Psychiatric Emergency and Acute Care, Lapeyronie Hospital, CHRU Montpellier, France
| | - Mitchell Cunningham
- School of Psychology, The University of Sydney, Sydney, North South Wales, Australia
| | - Jason M Nagata
- Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA
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13
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Ganson KT, Mitchison D, Rodgers RF, Cunningham ML, Murray SB, Nagata JM. Compulsive exercise among college students: 5-year time trends in prevalence and demographic, substance use, and mental health correlates. Eat Weight Disord 2022; 27:717-728. [PMID: 34024038 DOI: 10.1007/s40519-021-01210-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 05/08/2021] [Indexed: 12/19/2022] Open
Abstract
PURPOSE To provide 5-year time trends in prevalence and demographic, substance use, and mental health correlates of compulsive exercise among a national sample of college men and women. METHODS We analyzed 4 academic survey years (2016-2020; N = 8251) of the national (USA) Healthy Minds Study. Compulsive exercise was measured by self-report of any occurrence of "compulsive" exercise in the past 4 weeks. Unadjusted prevalence of compulsive exercise in the past 4 weeks was estimated across the 4 survey years by sex. Multiple logistic regression analyses were conducted among the pooled sample and stratified by sex to estimate the associations between compulsive exercise in the past 4 weeks and demographic, substance use, and mental health correlates. RESULTS Among the pooled sample, 11% (95% confidence interval [CI] 9.60-12.42%) of men and 17% (95% CI 15.86-18.24%) of women reported compulsive exercise in the past 4 weeks. Prevalence across the 4 survey years remained stable among men and women. Higher body mass index was associated with greater odds of any compulsive exercise in the past 4 weeks among men, while any sports participation was associated with greater odds of any compulsive exercise in the past 4 weeks among women. Compulsive exercise in the past 4 weeks was associated with greater odds of all mental health symptoms and illicit drug use among men and women, and higher odds of alcohol use among women. CONCLUSION Compulsive exercise is relatively common among college men and women and is associated with substance use behaviors and poor mental health symptoms. LEVEL OF EVIDENCE V, cross-sectional descriptive study.
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Affiliation(s)
- Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Toronto, ON, M5S 1V4, Canada.
| | - Deborah Mitchison
- School of Medicine, Translational Health Research Institute, Western Sydney University, Sydney, Australia
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Rachel F Rodgers
- APPEAR, Department of Applied Psychology, Northeastern University, Boston, MA, USA
- Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHRU, Montpellier, France
| | | | - Stuart B Murray
- Department of Psychiatry and the Behavioral Sciences, University of Southern California, Los Angeles, CA, USA
| | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
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14
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Gülüm IV, Soygüt G. Limited reparenting as a corrective emotional experience in schema therapy: A preliminary task analysis. Psychother Res 2021; 32:263-276. [PMID: 33910484 DOI: 10.1080/10503307.2021.1921301] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
AIM To construct a process model of limited reparenting as a corrective emotional experience using schema therapy (ST). METHOD We followed a task analytical approach, building two separate rational models based on the ST theory and our experience. Then, we constructed a final rational model. We tested our model in five therapy sessions. RESULTS The process began with noticing a schema activation, after which a complex, interwoven process occurred involving facilitation and validation of the client's experiences, exploration of schema origins, engaging the client's process, and responding to unmet needs within professional boundaries. The limited reparenting experience in ST involves the use of psychotherapeutic techniques and, crucially, how these techniques are used in line with the ST model deployed. CONCLUSION Our results provided a roadmap and clarified the important aspects of limited reparenting. Providing clients with healthy and potentially corrective emotional experiences, facilitating and validating the feelings, understanding schema origins, and being willing to provide limited reparenting are the key features of the ST. It is more important to comprehend the philosophy behind ST than to focus on the specific (cognitive, behavioral, interpersonal, experiential, etc.) techniques.
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Affiliation(s)
- I Volkan Gülüm
- Department of Psychological Counselling and Guidance, Dumlupinar University, Kütahya, Turkey
| | - Gonca Soygüt
- Department of Psychology, İstanbul Şehir University, İstanbul, Turkey
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McAulay C, Hay P, Mond J, Touyz S. Eating disorders, bipolar disorders and other mood disorders: complex and under-researched relationships. J Eat Disord 2019; 7:32. [PMID: 31528342 PMCID: PMC6740009 DOI: 10.1186/s40337-019-0262-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 08/22/2019] [Indexed: 02/07/2023] Open
Affiliation(s)
- Claire McAulay
- 1Clinical Psychology Unit, Brain & Mind Centre, University of Sydney, Sydney, Australia
| | - Phillipa Hay
- 2Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
| | - Jonathan Mond
- 3Centre for Rural Health, College of Health and Medicine, University of Tasmania, Sydney, Australia
| | - Stephen Touyz
- 1Clinical Psychology Unit, Brain & Mind Centre, University of Sydney, Sydney, Australia.,4Inside Out Institute, Charles Perkins Centre, Sydney Medical School, University of Sydney, Sydney, Australia
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