Relation between orthorexia nervosa and healthy orthorexia: A latent profile analysis

Orthorexic eating behaviors can be conceptualized as a bidimensional construct encompassing an orthorexia nervosa dimension (ON) and a healthy orthorexia dimension (HO). Although variable-centered studies showed that ON and HO are distinguishable orthorexic eating behaviors, the evidence of whether they can co-occur or be distinct in subgroups of individuals is still limited. The present study aimed to address previous person-centered studies' limitations by examining profiles of ON and HO among a convenience sample of 251 French-speaking Canadian adults (85.7% women; Mage = 33.56). Profile membership was examined as function of participants characteristics such as age, gender, body mass index, frequency of physical activity and sports and vegetarianism. The relation between profile membership, intuitive eating and disordered eating attitudes and behaviors was also assessed. Latent profile analysis (LPA) were used to estimate profiles of ON and HO. Results from LPA did not provide support for the distinguishability of ON and HO. Indeed, they revealed the presence of two profiles showing co-occurring levels of ON and HO that only differed quantitatively: low (68.9% of the sample; low levels of ON and HO) or moderate orthorexic eating behaviors (31.1%; moderate levels of ON and HO). Participants who declared being vegetarian and being more frequently involved in physical activities and sports were more likely to belong to the moderate orthorexic eating behaviors' profile. Finally, participants from the moderate orthorexic eating behaviors' profile showed higher levels of disordered eating attitudes and behaviors, whereas those from the low orthorexic eating behaviors' profile showed higher levels of intuitive eating. Findings from the present study question the distinguishability of ON and HO dimensions. They also suggest that, similarly to ON, HO is also related to higher eating and lifestyle preoccupations.

Profiles of body image concerns and their associations with disordered eating behaviors

Although body image concerns (BIC) are recognized as a core driver in the development of disordered eating behaviors, the combined role of various types of BIC remains underexamined. This study relied on latent profile analysis to identify the main configurations of self-reported BIC (i.e., body checking and avoidance, perceived physical appearance, and fear of negative appearance evaluation) observed in a sample of 419 French-Canadian individuals (Mage = 26.59, SDage = 9.23). The role of body mass index, sex, and age on profile membership was also examined, as well as the relation between profile membership and disordered eating behaviors (i.e., dieting, bulimia and food preoccupation, and oral control). Six distinct BIC profiles differing in terms of shape and level were identified, with women being more likely to display a profile characterized by higher levels of BIC. In turn, profiles characterized by higher levels of BIC were associated with more disordered eating behaviors. The present study can broaden our understanding of the onset and maintenance of disordered eating behaviors and inspire the development of more tailored body-image interventions.

Validation of a Virtual Environment to Induce State Social Physique Anxiety in Women with Obesity and Social Physique Anxiety

State Social Physique Anxiety (SPA), in contrast to Trait SPA, is triggered by specific situations that elicit SPA. To date, no research has used virtual reality (VR) to recreate a situation that may elicit State SPA. The purpose of this study is to validate a virtual environment (VE) that simulates an anxiogenic situation to induce State SPA in women with obesity and high SPA. The high SPA group consisted of 25 self-identified women living with obesity and high Trait SPA. The low SPA group consisted of 20 self-identified women with low SPA. All participants were immersed in a virtual swimming pool environment for 10 min using a virtual reality headset. After the immersion, State SPA and fear of being negatively judged felt during immersion were measured with self-report questionnaires. A questionnaire assessing unwanted negative side effects was administered before and after the immersion. Using an ANCOVA with Trait SPA as covariate, State SPA was found to be significantly higher in the high SPA group. Fear of being judged negatively was also significantly higher in the high SPA group. Unwanted negative side effects scores did not increase post-immersion in either group. This study documents the validity of a novel VE for inducing State SPA in women with obesity and high SPA.

Body appreciation around the world: Measurement invariance of the Body Appreciation Scale-2 (BAS-2) across 65 nations, 40 languages, gender identities, and age

The Body Appreciation Scale-2 (BAS-2) is a widely used measure of a core facet of the positive body image construct. However, extant research concerning measurement invariance of the BAS-2 across a large number of nations remains limited. Here, we utilised the Body Image in Nature (BINS) dataset - with data collected between 2020 and 2022 - to assess measurement invariance of the BAS-2 across 65 nations, 40 languages, gender identities, and age groups. Multi-group confirmatory factor analysis indicated that full scalar invariance was upheld across all nations, languages, gender identities, and age groups, suggesting that the unidimensional BAS-2 model has widespread applicability. There were large differences across nations and languages in latent body appreciation, while differences across gender identities and age groups were negligible-to-small. Additionally, greater body appreciation was significantly associated with higher life satisfaction, being single (versus being married or in a committed relationship), and greater rurality (versus urbanicity). Across a subset of nations where nation-level data were available, greater body appreciation was also significantly associated with greater cultural distance from the United States and greater relative income inequality. These findings suggest that the BAS-2 likely captures a near-universal conceptualisation of the body appreciation construct, which should facilitate further cross-cultural research.

Body image interventions within breast cancer care: A systematic review and concept analysis

There needs to be a consensus regarding the definition of body image in oncology the literature. This lack of agreement leads to conflicting results in psychosocial interventions aimed to improve body image among breast cancer patients. Through an instrumentalist approach, this systematic review aims to analyze how body image as a concept is described and operationalized in breast cancer studies with the focus to enhance body image through psychosocial interventions. Databases were searched in October 2022 and updated in February 2023 to find empirical studies reporting psychosocial intervention targeting body image efficacy. The results from 24 studies show many similarities and differences between the definitions (e.g. characteristics) and questionnaires (e.g. Cronbach's alpha coefficient) used to evaluate this concept. Most definitions include thoughts, feelings, and behaviors related to body image. Finally, the psychosocial implications are discussed. This systematic review is registered on the International Prospective Register of Systematic Reviews (PROSPERO; CRD42022326393).

Factors Associated with Excess Skin After Bariatric Surgery: a Mixed-Method Study

PURPOSE

After metabolic and bariatric surgery (MBS), many patients have excess skin (ES), which can cause inconveniences. Identifying factors related to ES quantity and inconveniences is crucial to inform interventions. The aim of this study was to identify sociodemographic, physical, psychosocial, and behavioral factors associated with ES quantity and inconveniences.

MATERIALS AND METHODS

A mixed-method study with a sequential explanatory design was conducted with 124 adults (92% women, Mage 46.5 ± 9.9 years, Mtime post-MBS 34.2 ± 27.6 months). During phase I, ES quantity (arms, abdomen, thighs) and inconveniences and sociodemographic, anthropometric, clinical, and behavioral outcomes were assessed. In phase II, 7 focus groups were performed with 37 participants from phase I. A triangulation protocol was completed to identify convergences, complementarities, and dissonances from quantitative and qualitative data.

RESULTS

Quantitative data indicate only ES quantity on arms was associated with ES inconveniences on arms (r = .36, p < .01). Total ES quantity was associated with maximal body mass index (BMI) reached pre-MBS (r = .48, p < .05) and current BMI (r = .35, p < .05). Greater ES inconvenience was associated with higher social physique anxiety and age (R2 = .50, p < .01). Qualitative data were summarized into 4 themes: psychosocial experiences living with ES, physical ailments due to ES, essential support and unmet needs, and beliefs of ES quantity causes.

CONCLUSION

Measured ES quantity is related to higher BMI, but not reported inconveniences. Greater self-reported ES quantity and inconveniences were associated with body image concerns.

A survey of eating styles in eight countries: Examining restrained, emotional, intuitive eating and their correlates

INTRODUCTION

Restrained, emotional and intuitive eating were examined in relation to each other and as correlates of participants' weight status, body image and self-esteem. In some past research, restrained and emotional eating have been associated with higher weight status and poorer mental health, while intuitive eating is more frequently linked to lower weight status and more positive well-being. However, these eating styles have rarely been examined together and never in a large cross-country sample.

METHOD

Six-thousand two-hundred and seventy-two (6272) emerging adults (M age = 21.54 years, SD = 3.13) completed scales from the Three-Factor Eating Questionnaire, the Eating Disorders Examination Questionnaire, the Intuitive Eating Scale-2, the Multidimensional Body Self Relations Questionnaire, the Rosenberg Self-Esteem Scale, and provided weight and height information that was used to calculate body mass index (BMI). Participants resided in Australia, Belgium, Canada, China, Italy, Japan, Spain and the United States and provided information using an online survey.

RESULTS

Path analyses for the entire sample revealed significant pathways between higher intuitive eating and higher body satisfaction and self-esteem, and lower BMIs among participants. Higher levels of restrained and emotional eating were associated with lower body satisfaction and self-esteem, and higher BMIs among participants. Minor cross-country differences were evident in these patterns of relations, but intuitive eating emerged as a consistent predictor across countries.

CONCLUSION

Overall, findings suggest that efforts should be made to increase intuitive eating among emerging adults and to support individual and macrolevel interventions to decrease restrained and emotional eating behaviours.

Psychometric properties of the Teruel Orthorexia Scale (TOS) among a French-Canadian adult sample

BACKGROUND

Psychometric properties of the Teruel Orthorexia Scale (TOS) have been examined in several languages (Arabic, English, Portuguese, Spanish, and Turkish), but not in French.

PURPOSE

The objective was to examine the psychometric properties of the TOS among a French-Canadian adult sample.

METHODS

Participants were 296 French-speaking Canadian adults (M = 34.2 years, SD = 11.9, 85.1% women). They completed the TOS alongside with several other measures (e.g., alcoholic consumption, cigarette smoking, disturbed eating attitudes and behaviors, frequency of physical activities, intuitive eating, vegetarian diet, and negative affect).

RESULTS

The results supported the a priori two-factor representation (orthorexia nervosa and healthy orthorexia) of the French version of the TOS and provided further support for the superiority of an exploratory structural equation modeling approach, relative to a confirmatory factor analytic approach. Furthermore, the results supported no differential item functioning as a function of respondents' characteristics (age, body mass index, diagnosis of eating disorders, frequency of physical activities, gender, and vegetarian diet). Latent mean differences were found in healthy orthorexia and orthorexia nervosa factors as a function of respondents' characteristics. Finally, significant correlations were found between TOS factors and convergent measures (alcohol consumption, cigarette smoking, disturbed eating attitudes and behaviors, intuitive eating, and negative affect).

CONCLUSION

The present study confirmed that the French version of the TOS has satisfactory psychometric properties (i.e., factor validity and reliability, no differential item functioning, and convergent validity).

LEVEL OF EVIDENCE

V, cross-sectional study.

The children's eating attitudes test: French validation of a short version

PURPOSE

Disordered eating attitudes and behaviors (DEAB) in childhood have been prospectively associated with eating disorders and obesity in adolescence. Therefore, evaluating DEAB in children with a reliable, sensitive and well-adapted scale is very important. The Children's Eating Attitudes Test (ChEAT) is one of the most popular measuring tools for DEAB in children, but no French version is available. Moreover, while completion time is an important factor to be considered when working with children, only one recent study proposed a shorter version of the ChEAT. Taking the previous works of Murphy and colleagues (2019) as a starting point, the current study aimed to provide the first French-speaking validated 14-item short version of the ChEAT.

METHODS

A sample of 1092 boys and girls aged between 8 and 12 years old were recruited in two urban areas in the province of Quebec, Canada. They completed the ChEAT, and their height and weight were measured at school. Factorial structure and internal consistency were assessed.

RESULTS

After the initial factorial analysis, two "vomiting (or purging)" items were yielded as problematic and were thus removed from the analysis. The remaining 12 items provided a good fit to the data and a good internal consistency. Moreover, the factorial structure was proved to be invariant across sexes.

CONCLUSION

This study is the first to provide a French assessment of DEAB in elementary school children. The French short version of the ChEAT provided a quick and reliable assessment for DEAB with non-clinical children population and could be used as a screening tool, even though no cut-off was established yet.

LEVEL OF EVIDENCE

Cross-sectional, descriptive study, Level V.

Psychometric Properties of a French Version of the Perceived Motor Competence in Childhood Questionnaire

In this study, we examined the psychometric properties of a French version of the Perceived Motor Competence in Childhood (PMC-C) questionnaire. The participants were 219 French-speaking children (aged 5-12 years), recruited from elementary schools in the Canadian Province of Quebec. Results supported the validity and reliability of a second-order confirmatory factor analytic (CFA) model, including one higher-order factor. Additional analyses supported the complete measurement invariance of the first- and second-order factor structure across sex and indicated no differential item functioning or latent mean differences in PMC-C factors as a function of selected predictors (i.e., age, body mass-index and physical activity/sport involvement). Thus, this French version of the PMC-C has satisfactory psychometric properties (i.e., factor validity and reliability, measurement invariance and differential item functioning) and can be used to assess French-speaking children’s perceived motor competence.

Assessing positive body image, body satisfaction, weight bias, and appearance comparison in emerging adults: A cross-validation study across eight countries

Positive body image refers to individuals' ability to conceptualize their bodies with love, respect, and appreciation. The study of positive body image is relatively new, and instruments used to investigate this multi-faceted construct have received limited use in non-English speaking countries. Thus, the aim of this investigation is to consider four measures that are associated with positive body image across eight different countries. Participants (n = 6272) completed the Body Appreciation Scale-2, the Body Areas Satisfaction Scale, the Physical Appearance Comparison Scale, and the Weight Bias Internalization Scale. Multi-group confirmatory factor analyses (MG-CFAs) and item-response theory (IRT) models were used to examine the measurement invariance of these surveys. Our results generally suggest that positive body image, weight bias, and appearance comparison can be assessed using brief assessments and that these four instruments can be used in different countries, but care should be taken to consider individuals' gender, BMI, and socio-economic position.

Cross-Country Measurement Invariance and Effects of Sociodemographic Factors on Body Weight and Shape Concern-Related Constructs in Eight Countries

The aim of this study was to examine the cross-country invariance of five well-established measures of body weight and shape concern-related attitudes and behaviors (i.e., drive for leanness, drive for muscularity, strategies to increase muscle, strategies to lose weight, and weight and shape concerns). A secondary objective was to examine the effects of several sociodemographic factors (age, BMI, socioeconomic status, and gender) on item and latent factor scores of these constructs. A total of 6272 emerging adults (4218 women; M_age = 21.46, SD = 3.11) from Australia, Belgium, Canada, China, Italy, Japan, Spain, and the U.S. completed a self-report online survey as part of a larger study. Overall, support for partial invariance both across countries and in terms of the considered sociodemographic factors was found for reduced versions of the five measures. Significant differences in latent means were found across countries, these being of greater magnitude for drive for leanness and strategies to lose weight. The considered sociodemographic factors (most notably BMI and gender) were associated with the latent mean scores of the assessed constructs. The present study contributes to current literature by providing cross-cultural invariant versions of several measures of relevance in the field of body image.

A cross-country examination of emotional eating, restrained eating and intuitive eating: Measurement Invariance across eight countries

This study examined the measurement invariance of three scales that assessed emotional eating, restrained eating, and intuitive eating across eight countries (Australia, Belgium, Canada, China, Italy, Japan, Spain and the United States) in order to determine their suitability for cross-country body image research. A total of 6272 young adults took part in this study. Participants completed an online survey including the Emotional Eating subscale of the Three Factor Eating Questionnaire-Revised 21, the Restraint subscale of the Eating Disorder Examination Questionnaire, and the Reliance on Hunger and Satiety Cues subscale of The Intuitive Eating Scale-2. Multi-group confirmatory factor analysis was used to evaluate potential cross-country differences in functioning of the measures. Partial invariance for all three scales was found, with only minor levels of non-invariance identified. Multiple indicator multiple cause models identified BMI and gender as potential influences on scores for these measures. Sources of invariance across groups are discussed, as well as implications for further substantive research across countries involving these measures.

Vinegar and weight loss in women of eighteenth-century France: a lesson from the past

This short note reports the eighteenth-century account of Mademoiselle Lapaneterie, a French woman who started drinking vinegar to lose weight and died one month later. The case, which was first published by Pierre Desault in 1733, has not yet been reported by present-day behavioural scholars. Similar reports about cases in 1776 are also presented, confirming that some women were using vinegar for weight loss. Those cases can be conceived as a lesson from the past for contemporary policies against the deceptive marketing of potentially hazardous weight-loss products.

The Breast Size Satisfaction Survey (BSSS): Breast size dissatisfaction and its antecedents and outcomes in women from 40 nations

The Breast Size Satisfaction Survey (BSSS) was established to assess women's breast size dissatisfaction and breasted experiences from a cross-national perspective. A total of 18,541 women were recruited from 61 research sites across 40 nations and completed measures of current-ideal breast size discrepancy, as well as measures of theorised antecedents (personality, Western and local media exposure, and proxies of socioeconomic status) and outcomes (weight and appearance dissatisfaction, breast awareness, and psychological well-being). In the total dataset, 47.5 % of women wanted larger breasts than they currently had, 23.2 % wanted smaller breasts, and 29.3 % were satisfied with their current breast size. There were significant cross-national differences in mean ideal breast size and absolute breast size dissatisfaction, but effect sizes were small (η² = .02-.03). The results of multilevel modelling showed that greater Neuroticism, lower Conscientiousness, lower Western media exposure, greater local media exposure, lower financial security, and younger age were associated with greater breast size dissatisfaction across nations. In addition, greater absolute breast size dissatisfaction was associated with greater weight and appearance dissatisfaction, poorer breast awareness, and poorer psychological well-being across nations. These results indicate that breast size dissatisfaction is a global public health concern linked to women's psychological and physical well-being.

Development and testing of a model for risk and protective factors for eating disorders and higher weight among emerging adults: A study protocol

Research has demonstrated that eating disorders (ED) and higher weight have lifetime co-occurrence suggesting that they may be best considered within a common etiological model. Although we know that body dissatisfaction is likely to be a risk factor for both outcomes, other proposed risk and protective factors for each condition have not been adequately explored. The current paper tests a conceptual model that is based on a review of the existing literature from both areas of scholarship. It considers biological, sociocultural, psychological, and behavioral factors that may contribute to both outcomes. The model will be tested in a longitudinal design with an initial sample of 600 emerging adults (aged 18-30) per country in nine different countries (total sample = 5400 participants). Questionnaires will be completed online on two occasions, 12 months apart. The first full phase of the study commenced in July 2018, the same time Body Image was approached to publish this protocol paper (the final revised paper was submitted in September 2019), and data collection will be finalized in December 2019. Multi-group path analysis will identify the biopsychosocial predictors - both cross-sectionally and longitudinally - of both ED and higher weight, and how these vary across countries and gender.

Psychometric Properties of the Body Checking Questionnaire (BCQ) and of the Body Checking Cognitions Scale (BCCS): A Bifactor-Exploratory Structural Equation Modeling Approach

This research sought to assess the psychometric properties of the French versions of the Body Checking Questionnaire and the Body Checking Cognitions Scale among community samples. A total sample of 922 adolescents and adults was involved in a series of two studies. The results from the first study supported factor validity and reliability of responses obtained on these two measures, and showed that both measures were best represented by a bifactor-exploratory structural equation modeling representation of the data. The results from the second study replicated these conclusions, while also supporting the measurement invariance of the bifactor-exploratory structural equation modeling solution and the equivalence of the correlations among the two measures (i.e., convergent validity) across samples. This second study also supported the criterion-related validity of ratings on both measures with measures of global self-esteem, physical appearance, social physique anxiety, fear of negative appearance evaluation, and disturbed eating attitudes and behaviors. Finally, the results of this last study also supported the measurement invariance and lack of differential item functioning of both measures in relation to sex, age, diagnosis of eating disorders, and body mass index.

Psychological Meanings of Eating Disorders and Their Association With Symptoms, Motivation Toward Treatment, and Clinical Evolution Among Outpatients

Unlike patients suffering from egodystonic disorders, people with eating disorders sometimes attribute positive meanings to their symptoms, and this attribution process contributes to the maintenance of the disorder. This study aims at exploring psychological meanings of eating disorders and their associations with symptoms, motivation toward treatment, and clinical evolution. Eighty-one adults with an eating disorder (anorexia nervosa, n = 46 and bulimia nervosa, n = 35) treated in a day-hospital program were asked, each week over an 8-week period, to identify the psychological meanings they ascribed to their eating disorder. Avoidance was the most frequently identified meaning, followed by mental strength, security, death, confidence, identity, care, and communication. Avoidance was more frequently mentioned by participants with bulimia than in cases of anorexia. Security and mental strength were associated with less motivation toward treatment. Death was associated with more depressive and anxious symptoms. An exploratory factor analysis showed that these meanings formed three main dimensions: Avoidance, Intrapsychic, and Relational. Findings suggest that psychological meanings associated with eating disorders can be assessed and used as a clinical tool to increase treatment acceptability and effectiveness.

Psychometric properties of the Weight Self-Stigma Questionnaire (WSSQ) among a sample of overweight/obese French-speaking adolescents

PURPOSE

The Weight Self-Stigma Questionnaire (WSSQ) was recently developed to assess the internalization of weight stigma among English-speaking overweight and obese adults. The objective of the present study was to develop and examine the psychometric properties of a French version of the WSSQ, as well as its applicability to adolescents.

METHODS

The sample comprised 156 overweight and obese adolescents (81 boys, 75 girls, M_age = 16.31). The factor validity and the convergent validity of the French version of the WSSQ were examined using a confirmatory factor analysis and a structural equation model, respectively.

RESULTS

The a priori two-factor structure of the WSSQ and the composite reliability of its subscales (self-devaluation and fear of enacted stigma) were supported. Convergent validity analyses revealed that both WSSQ subscales were significantly and (a) negatively correlated with measures of self-esteem and physical appearance, and (b) positively correlated with measures of anxiety, depression, fear of negative appearance evaluation, and eating-related pathology (fear of getting fat, eating-related control, food preoccupation, vomiting-purging behaviors, and eating-related guilt subscales). However, no significant relation was found between the WSSQ subscales and body mass index.

CONCLUSION

These results suggest that the French version of the WSSQ has acceptable psychometric properties and can be used to assess weight self-stigma among overweight and obese adolescents.

Can weight predict academic performance in college students? An analysis of college women's self-efficacy, absenteeism, and depressive symptoms as mediators

Over a third of American college students are either overweight or obese, which has been suggested to negatively impact their academic achievement.

OBJECTIVE

This study seeks to better understand the relationship between body mass index (BMI) and grade point average (GPA), while examining potential mediators of this association.

PARTICIPANTS AND METHODS

The sample consists of 298 college women who volunteered to complete online questionnaires between October and December 2014.

RESULTS

Although no significant differences were noted for sociodemographic variables, overweight and obese female students were found to report lower GPA and academic self-efficacy as well as higher depressive symptoms, compared with their normal-weight counterparts. Academic self-efficacy partially mediated the relationship between BMI and GPA.

CONCLUSIONS

To foster better academic achievement in female college students, and especially for those who are overweight and obese, strategies for improving self-efficacy and adaptation to college should be implemented.

Prevalence and correlates of bullying perpetration and victimization among school-aged youth with intellectual disabilities: A systematic review

Recent literature reviews show that bullying perpetration and victimization are major public health concerns for typically developing (TD) youth. Nevertheless, the magnitude of this phenomenon among youth with intellectual disabilities (ID) remains unclear. Therefore, the purpose of this review is to provide a synthesis of the empirical studies examining the prevalence and correlates of bullying perpetration and victimization among youth with ID. A systematic literature search was performed and 11 studies met the inclusion criteria. The findings from these studies showed weighted mean prevalence rates of general bullying perpetration, bullying victimization and both of 15.1%, 36.3%, and 25.2%, respectively. Weighted mean prevalence rates of bullying perpetration and victimization differed according to the characteristics of the studies (e.g., assessment context, school setting, information source, type of measures, time frame). Additionally, high weighted mean prevalence rates of physical (33.3%), verbal (50.2%), relational (37.4%), and cyber (38.3%) victimization were found among youth with ID. When youth with ID were compared to youth with other disabilities or TD peers, no clear differences were found. Finally, the present review shows that correlates of bullying perpetration and victimization in this population remain understudied.

Prevalence of School Bullying Among Youth with Autism Spectrum Disorders: A Systematic Review and Meta-Analysis

The true extent of school bullying among youth with autism spectrum disorders (ASD) remains an underexplored area. The purpose of this meta-analysis is to: (a) assess the proportion of school-aged youth with ASD involved in school bullying as perpetrators, victims or both; (b) examine whether the observed prevalence estimates vary when different sources of heterogeneity related to the participants' characteristics and to the assessment methods are considered; and (c) compare the risk of school bullying between youth with ASD and their typically developing (TD) peers. A systematic literature search was performed and 17 studies met the inclusion criteria. The resulting pooled prevalence estimate for general school bullying perpetration, victimization and both was 10%, 44%, and 16%, respectively. Pooled prevalence was also estimated for physical, verbal, and relational school victimization and was 33%, 50%, and 31%, respectively. Moreover, subgroup analyses showed significant variations in the pooled prevalence by geographic location, school setting, information source, type of measures, assessment time frame, and bullying frequency criterion. Finally, school-aged youth with ASD were found to be at greater risk of school victimization in general, as well as verbal bullying, than their TD peers. Autism Res 2016, 9: 601-615. © 2015 International Society for Autism Research, Wiley Periodicals, Inc.

Body Mass Index Accuracy in Preadolescents: Can We Trust Self-Report or Should We Seek Parent Report?

OBJECTIVES

To assess the accuracy of self- and parent-report of weight, height, and body mass index (BMI) in children between 8 and 12 years of age and to determine whether self- or parent-report should be preferred for preadolescents' subjective measures.

STUDY DESIGN

Through at-home questionnaires, 875 preadolescent children (44% boys; 56% girls) and their parents (N = 821) were asked to report the children's weight and height. Objective weight and height were measured at school by trained interviewers.

RESULTS

Correlations between objective, self-reported, and parent-reported measures were strong for weight, height, and BMI, but children and parents generally underestimated the children's weight by about 1 kg, their height by less than 1 cm, and their BMI by less than 0.25 kg/m(2). The magnitude of the underestimation varied by age, sex, and BMI category, with older children, girls, and children in the overweight and obese BMI categories underestimating their weight to a greater extent. Weight estimates provided by girls' parents tended to be lower than the real values more often than those of boys' parents.

CONCLUSIONS

Children and parents are likely to misreport children's weight, height, and BMI. For most youths aged 8 years of age and older, self-report appears as accurate as parent-report and could, therefore, be used interchangeably.

Heterogeneity of sex-stratified BMI trajectories in children from 8 to 14 years old

OBJECTIVE

Describe and predict sex-stratified trajectories of weight change in youths transitioning from childhood to adolescence.

METHODS

Using an accelerated longitudinal design, 461 children between 8 and 12 years old at baseline were followed over three years. Body mass index was calculated from self-reported height and weight. Latent class growth analysis was used to identify BMI trajectories and multinomial logistic regressions, to predict group membership.

RESULTS

A four-group heterogeneous trajectory model emerged for boys and girls alike. Characteristics of the trajectories differed between sexes and no obesity group was found for boys. Sociocultural factors, such as media influence, body dissatisfaction, weight victimization, awareness of thin-ideal standards and related pressures were important correlates of trajectory membership.

CONCLUSION

BMI trajectories during preadolescence are stable over time for heavier children. Body image concerns and weight stigmatization stand out as important factors in the prediction of developmental weight trajectories and could therefore be integrated in weight gain prevention programs for children of all weights as well as in weight management interventions for overweight and obese children.

Lifestyle interventions targeting changes in body weight and composition among youth with an intellectual disability: A systematic review

Over the past three decades, the potential effects of lifestyle interventions targeting changes in body weight and composition (weight, body mass index, fat mass, waist circumference) among adults with an intellectual disability (ID) have been examined in various systematic reviews. Nevertheless, since the middle of the 1980s, the potential effects of these interventions for youth with an ID remain an open question. The purpose of this article is to review the effects of lifestyle interventions targeting changes in body weight and composition among youth with an ID. This review will focus on changes in body weight and composition, healthy lifestyle, and secondary health conditions. A systematic review of English- and French-language studies, published between 1981 and 2013, was performed on Academic Search Complete, PsycARTICLES, Medline and Scopus. The nine studies included in this review focused mainly on: a sample with a wide age range (e.g., 7-22 years); males; overweight-obese youth having a mild-to-moderate ID with Down or Prader-Willi syndrome; physical activity interventions; cohort pre- and post-test designs with/without a control group; and changes in body weight and composition. Taken together, results from these studies suggest successful changes in weight, body mass index and fat mass. However, intervention effects on healthy lifestyle and secondary health conditions are scarce and inconclusive. Given the weaknesses of the reviewed studies, the present findings should be considered preliminary and indicative of the need for future research.

[Are mental health disorders' characteristics such as presence and severity related to the nature of a crisis, its dangerousness and the types of services offered?]

The mandate of crisis centres varies substantially from one country to the next according to the government policies in effect. In the United States, crisis centres were developed based on Caplan's theory, which defines crisis as a psychosocial disorganization following a life event that is resolved with a return to balance. This approach aims at preventing the onset of mental health disorders through short-term intervention. It is different in Quebec, where crisis centres were developed in a deinstitutionalization context and ought to constitute an alternative to hospitalisation. Such mandate of Quebec crisis centres is not necessarily of the preventive nature associated with Caplan's theory and it has led to services having to be adapted to a heterogeneous clientele that may or may not suffer from mental health problems. It has implications related to the crisis characteristics such as its nature, intensity, and dangerosity, as well as implications regarding the organization of crisis centre services, which have been the object of few studies so far.

OBJECTIVE

The present study aims at distinguishing clinical profiles of crisis centre callers according to the presence or absence of a mental health disorder and its nature, that is severe and persistent (psychotic or bipolar disorder) or not (mood, anxiety or personality disorder). In order to do so, participants are compared on the characteristics of the crisis and the services they received.

METHOD

In this descriptive study, the files of 1170 new assistance applicants are retrospectively analyzed based on a predetermined grid that was used to collect data according to the main clinical characteristics of persons in distress, as recognized in the literature. The subgroup of persons presenting a psychotic or bipolar disorder was examined separately from the one comprising persons with an anxiety, mood or personality disorder because of its clinical complexity, which generally requires intensive, multidisciplinary follow-up.

RESULTS

Among the new applicants, 48% had a mental health disorder and, of these, 9% reported a serious mental health disorder, that is, a psychotic or bipolar disorder. The results indicate that having an anxiety-, mood- or personality-type disorder is associated with a higher probability of reporting stressful interpersonal-type events, a more intense crisis, as well as a greater risk of auto-aggressive behaviours. Meanwhile, persons with a psychotic or bipolar disorder are more frequently provided with accommodations and more likely to receive intensive and support services, such as emergency interventions or the use of the Act respecting the protection of persons whose mental state presents a danger to themselves or others (P-38).

CONCLUSIONS

This descriptive portrait of the crisis centre clientele contributes to the reflection on differential intervention with persons in a crisis situation. It appears important to take an interest in the presence and type of mental health disorders of crisis centre callers, since these characteristics help to better foresee not only the nature and intensity of the crisis but also the type of services required. However, Quebec crisis centres have to respond to the needs of a heterogeneous clientele without having access to a typology and a theoretical model that consider this clinical diversity. Other studies should be conducted to validate, on the one hand, a crisis typology that would make it easier for caseworkers to collect data for evaluation purposes and, on the other hand, a differential intervention model.

Trajectories of eating and clinical symptoms over the course of a day hospital program for eating disorders

Although it is well-established that day hospital programs for eating disorders significantly reduce clinical symptoms, the pre-test/post-test designs that were previously used do not provide information regarding the trajectory of symptoms during treatment. This study observed, on a weekly basis, the evolution of symptoms of 61 women suffering from eating disorders engaged in a day hospital program, and compared the trajectories of specific subgroups of patients. Results show that (a) the first half of the program was crucial for symptom changes; (b) although completers and non-completers presented similar initial improvement, their trajectories rapidly differentiated; and (c) poorer respondents initially reported more symptoms, showed a slower improvement, and never reached the non-clinical zone, whereas better-respondents reached the non-clinical cut-off point more rapidly.

Comorbid Diabetes and Eating Disorders in Adult Patients

Purpose

The lack of research concerning treatment for individuals with diabetes mellitus (DM) and comorbid eating disorders (ED) contributes to the gulf between the psychosocial needs of individuals with the two conditions and the treatment they receive. Empirical evidence has established that the prognosis of patients with this comorbid diagnosis (ED-DM) is poor in the absence of a specialized DM treatment specifically adapted to ED. In individuals with DM, comorbid ED is associated with numerous complications. Despite these interactions, current knowledge about the comorbid diagnosis is limited, and eating disorders in patients with diabetes often remain undiagnosed. This article presents standard procedures for assessment and optimal therapeutic interventions for patients with ED and DM.

Conclusion

In patients with diabetes, problematic eating behaviors and symptoms should be assessed routinely. When an eating disorder is detected, diabetes management needs to be adapted, binge eating or medication misuse needs to be addressed, and eating disorder specialists should be included in the multidisciplinary team.

Developmental pathways of eating problems in adolescents

OBJECTIVE

To examine the developmental eating trajectories of adolescents and identify psychological correlates and risk factors associated with those trajectories.

METHOD

Seven hundred thirty-nine adolescents completed self-reported measures of eating problems, internalizing and externalizing behaviors, alcohol and drug use, peer victimization, and depression.

RESULTS

Five eating trajectories were obtained. The proportions of males and females were the same in the increasing eating problems trajectory. For both genders, internalizing and externalizing problems were identified as associated risk factors of an eating pathology and reporting at least some eating problems was associated with an increased likelihood of psychological problems. Other risk factors found only in boys were frequency of drug use, victimization, and depressive symptoms.

CONCLUSION

Externalizing problems in girls and internalizing behaviors in boys with disordered eating should not be overlooked. Atypical eating behaviors in boys are of particular concern since it increases their risk of cooccurring psychopathology.

Frequent alteration of DNA damage signalling and repair pathways in human colorectal cancers with microsatellite instability

Accumulation of frameshift mutations at genes containing coding mononucleotide repeats is thought to be the major molecular mechanism by which mismatch repair-deficient cells accumulate functional alterations. These mutations resulting from microsatellite instability (MSI) can affect genes involved in pathways with a putative oncogenic role, but may also arise in genes without any expected role in MSI carcinogenesis because of the high mutation background of these tumours. We here screened 39 MSI colorectal tumours for the presence of mutations in 25 genes involved in DNA damage signalling and repair pathways. Using a maximum likelihood statistical method, these genes were divided into two different groups that differed significantly in their mutation frequencies, and likely represent mutations that do or do not provide selective pressure during MSI tumour progression. Interestingly, the so-called real-target mutational events were found to be distributed among genes involved in different functional pathways of the DNA metabolism, for example, DNA damage signalling (DNA-PKcs, ATR), double-strand break (DSB) repair (DNA-PKcs, RAD50), mismatch repair (MSH3, MSH6, MBD4) and replication (POLD3). In particular, mutations in MRE11 and/or RAD50 were observed in the vast majority of the tumours and resulted in the concomitant loss of immunohistochemical expression of both proteins. These data might explain why MSI colorectal cancers (CRC) behave differently in response to a wide variety of chemotherapeutic agents, notably those targeting DNA. More generally, they give further insights into how MSI leads to functional changes with synergistic effects in oncogenic pathways.

The eating disturbed spectrum in relation with coping and interpersonal functioning

Although much has been written with regards to the interpersonal functioning of eating-disordered women, research in the domain of eating disorders (ED) has still overlooked the complex relationships between stressful life events, coping styles, social and marital support while considering the ED spectrum.

OBJECTIVE

This study evaluates to what extent stressful life events, coping styles, and social support represent useful concepts for differentiating between four groups of participants with varying severity of eating preoccupations and disturbances.

METHOD

One hundred twenty-five participants were divided into four groups: 40 women suffering from ED, 21 women in remission from an ED, 33 women with intense weight and shape preoccupations, and 31 women without eating preoccupations. Each participant completed the Eating Disorder Evaluation, as well as questionnaires concerning stressful life events, coping styles, social support, and couple satisfaction.

RESULTS

There were significant differences between the groups in terms of negative impact of stressful events, social support, as well as task-oriented and emotion-oriented coping styles. Significant differences were not found between the groups for couple satisfaction.

CONCLUSION

It appears that accurate cognitive appraisal of stressful situations, adaptive coping styles and improvement of the social network represent interesting dimensions to include in prevention and treatment programs for ED. Moreover, for women in remission from an ED, an effective relapse prevention strategy could be to learn to make better use of their social network.

Self-help for bulimia nervosa: a randomized controlled trial

OBJECTIVE

The authors examined the effectiveness of unguided self-help as a first step in the treatment of bulimia nervosa.

METHOD

A total of 85 women with bulimia nervosa who were on a waiting list for treatment at a hospital-based clinic participated. The patients were randomly assigned to receive one of two self-help manuals or to a waiting list control condition for 8 weeks. One of the self-help manuals addressed the specific symptoms of bulimia nervosa (cognitive behavior self-help), while the other focused on self-assertion skills (nonspecific self-help).

RESULTS

Twenty patients (23.5%) dropped out of the study. The data were analyzed with intention-to-treat analysis. Although the group-by-time interaction for binge eating and purging was not statistically significant, simple effects showed that there was a significant reduction in symptom frequency in both self-help conditions at posttreatment but not in the waiting list condition. There were no statistically significant changes in levels of dietary restraint, eating concerns, concerns about shape and weight, or general psychopathology. A greater proportion of patients in the cognitive behavior self-help (53.6%) and nonspecific self-help (50.0%) conditions reported at least a 50% reduction in binge eating or purging at posttreatment, compared with the waiting list condition (31.0%). A lower baseline knowledge about eating disorders, more problems with intimacy, and higher compulsivity scores predicted a better response.

CONCLUSIONS

The findings suggest that a subgroup of patients with bulimia nervosa may benefit from unguided self-help as a first step in their treatment. Cognitive behavior self-help and nonspecific self-help had equivalent effects.