Participant Acceptability of Questionnaires Impacts Sexual Victimization Prevalence Rates

Obtaining accurate prevalence rates of sexual violence is made difficult by discrepancies in self-report questionnaires. Thus, the current study sought to explore participants' perceptions of acceptability (i.e., perceived difficulty and preference) as a potential mechanism of discrepancy between different questionnaires. Participants were 673 college students who completed two frequently used sexual victimization questionnaires, the Sexual Experiences Survey-Short Form Victimization (SES-SFV) and the Post-Refusal Sexual Persistence Scales-Victimization (PRSPS-V). Participants then answered questions about each measure's perceived difficulty and their preference between the two. Participants found the PRSPS-V easier to understand and preferred it 2.5 to 1 over the SES-SFV. Preference was related to reporting; participants who preferred the PRSPS-V reported more instances of sexual victimization on the PRSPS-V by 9.8%. Our results indicate that acceptability impacts reported prevalence rates and is one mechanism of discrepancy between questionnaires. Thus, researchers may wish to consider acceptability when choosing sexual victimization questionnaires.

Predicting eating disorder and anxiety symptoms using disorder-specific and transdiagnostic polygenic scores for anorexia nervosa and obsessive-compulsive disorder

BACKGROUND

Clinical, epidemiological, and genetic findings support an overlap between eating disorders, obsessive-compulsive disorder (OCD), and anxiety symptoms. However, little research has examined the role of genetics in the expression of underlying phenotypes. We investigated whether the anorexia nervosa (AN), OCD, or AN/OCD transdiagnostic polygenic scores (PGS) predict eating disorder, OCD, and anxiety symptoms in a large developmental cohort in a sex-specific manner.

METHODS

Using summary statistics from Psychiatric Genomics Consortium AN and OCD genome-wide association studies, we conducted an AN/OCD transdiagnostic genome-wide association meta-analysis. We then calculated AN, OCD, and AN/OCD PGS in participants from the Avon Longitudinal Study of Parents and Children to predict eating disorder, OCD, and anxiety symptoms, stratified by sex (combined N = 3212-5369 per phenotype).

RESULTS

The PGS prediction of eating disorder, OCD, and anxiety phenotypes differed between sexes, although effect sizes were small. AN and AN/OCD PGS played a more prominent role in predicting eating disorder and anxiety risk than OCD PGS, especially in girls. AN/OCD PGS provided a small boost over AN PGS in the prediction of some anxiety symptoms. All three PGS predicted higher compulsive exercise across different developmental timepoints [β = 0.03 (s.e. = 0.01) for AN and AN/OCD PGS at age 14; β = 0.05 (s.e. = 0.02) for OCD PGS at age 16] in girls.

CONCLUSIONS

Compulsive exercise may have a transdiagnostic genetic etiology, and AN genetic risk may play a role in the presence of anxiety symptoms. Converging with prior twin literature, our results also suggest that some of the contribution of genetic risk may be sex-specific.

Valid for who? A preliminary investigation of the validity of two sexual victimization questionnaires in men and sexual minorities

The #MeToo movement illuminated vast numbers of people who experienced sexual violence, but the exact scope and impact, especially among under-studied populations (e.g., men and sexual minorities) is unclear, due in part to measurement issues. Our objective was to compare the validity of two measures of sexual violence victimization: The Sexual Experiences Survey - Short Form Victimization (SES-SFV) and The Post-Refusal Sexual Persistence Scale - Victimization (PRSPS-V). Participants were 673 college students who first completed the Rape Empathy for Victims (REM-V) and then the SES-SFV and PRSPS-V (counter-balanced). We found strong evidence of convergent validity for the PRSPS-V with correlations ranging from r = .57 - 88. Convergent validity correlations were strongest for sexual minority women (r = .88) and weakest for heterosexual men (r = .57). We also found evidence of differential validity for the SES-SFV and PRSPS-V. For heterosexual women, rape empathy was correlated to victimization on both questionnaires (r = .25 - .29). However, for heterosexual men, only scores on the SES-SFV were correlated with rape empathy for victims (r = .19). For sexual minorities there appeared to be differences between PRSPS-V only victims and those who reported victimization on both questionnaires in rape empathy (F = 2.65, p = .053). These results provide researchers a starting point for improving these questionnaires to collect more accurate data that helps improve the ability to detect cases of sexual victimization and thus, prevent and heal sexual victimization, especially in understudied populations such as men and sexual minorities.

An Initial Test of the Tactic-First and Item-Order Hypotheses: Accounting for Response Discrepancies in Sexual Victimization Questionnaires

Reported prevalence rates of sexual violence range widely in the literature, even in the same sample when using two different questionnaires of the same construct. These discrepancies are concerning as they indicate we may be underestimating the rate of sexual violence and, therefore, resources and treatment for victims. Thus, the current study aimed to investigate two mechanisms that may contribute to differences in reported prevalence rates across the literature and discrepancies within studies: the tactic-first and item-order hypotheses. Participants were 265 MTurk workers whom all completed the Post-Refusal Sexual Persistence Scale (PRSPS), then were randomly assigned to one of two versions of a tactic-first Sexual Experiences Survey (T-SES). Experimental conditions varied in the item order of the T-SES, one condition received the traditional hierarchical item order (n = 130) while the other received a randomized item order (n = 135). Our results suggest strong support for the tactic-first hypothesis; victimization prevalence rates on the T-SES were double compared to the traditional SES (54.1 vs. 19.8%) in prior research. Further, in both conditions, victimization prevalence rates were statistically equivalent between the PRSPS (62.6%) and the tactic-first SESs (56.2 and 54.1%), χ²(1) < 2.5, p ≈ .1 -.7, contrary to prior research. We did not find support for the item-order hypothesis; there were few differences between item-order conditions. Our findings indicate that unintentional underreporting remains a threat to validity in sexual violence assessment, and continued research into the mechanisms of measurement is warranted.

The Assessment of Forced Penetration: A Necessary and Further Step Toward Understanding Men's Sexual Victimization and Women's Perpetration

A unique form of sexual victimization that often goes undiscussed and, therefore, underassessed is that of being forced to penetrate another person (i.e., forced penetration). Due to forced penetration being a relatively novel addition to the definition of rape, there is a lack of assessment tools that identify forced penetration cases. Thus, the goal of this study was to assess the utility and validity of new items designed to assess forced penetration. More than 1,000 participants were recruited across three different studies to assess forced penetration victimization and perpetration. The rate of forced penetration victimization ranged from 4.51% to 10.62%. Among men who reported victimization of any type, 33.8% to 58.7% of victimized men reported experiencing forced penetration across the samples, suggesting this experience is common. All new and unique cases of sexual victimization identified by the forced penetration items were those of heterosexual men. These findings suggest that assessing for forced penetration would increase the reported prevalence rates of sexual victimization, particularly in heterosexual men (and correspondingly, rates of perpetration in women).

Weight suppression and weight elevation are associated with eating disorder symptomatology in women age 50 and older: Results of the gender and body image study

OBJECTIVE

Weight suppression (WS), the difference between highest past non-pregnancy weight and current weight, predicts negative outcomes in eating disorders, but the impact of WS and related weight constructs are understudied in nonclinical, midlife populations. We examined WS (current weight < highest weight) and weight elevation (WE), the opposite of WS (current weight > lowest weight) and their associations with eating psychopathology in women aged 50+.

METHOD

Participants were a community-based sample (N = 1,776, M_age  = 59) who completed demographic and eating psychopathology questions via online survey. WS, WE, and WS × WE were tested as predictors of outcome variables; BMI and medical conditions that affect weight were controlled for.

RESULTS

Individuals that were higher on WS and WE were most likely to engage in current weight loss attempts, dieting in the past 5 years, and extreme lifetime restriction. Individuals with higher WS were more likely to experience binge eating, greater frequency of weight checking, overvaluation of shape and weight, and lifetime fasting. Individuals with higher WE were more likely to report negative life impacts of eating and dieting. Higher WS and WE each predicted higher levels of skipping meals over the lifetime.

DISCUSSION

This novel study investigated WS in midlife women and introduced a new conceptualization of weight change (WE) that may be more relevant for aging populations given that women tend to gain weight with age. The findings implicate the utility of investigating both WS and WE as factors associated with eating psychopathology in midlife women.

Sweet taste preference in binge-eating disorder: A preliminary investigation

Research suggests that individuals with high liking for sweets are at increased risk for binge eating, which has been minimally investigated in individuals with binge-eating disorder (BED). Forty-one adults (85% female, 83% white) with binge eating concerns completed a sweet taste test and measures of eating disorder behaviors and food cravings. A subset of participants with BED completed an oral glucose tolerance test (OGTT; N=21) and a 24-hour dietary recall (N=26). Regression models were used to compare highest sweet preferers (HSP [N=18]) to other sweet preferers (OSP [N=23]) and were used to assess associations between sweet taste preference and outcome variables. Effect sizes (ηp²) for differences between HSP and OSP ranged from small (≤0.01) to large (≥0.24); group differences were statistically nonsignificant except for 24-hour caloric intake (ηp²=0.16, p=0.04), protein intake (ηp²=0.16, p=0.04), and insulin sensitivity index (ηp²=0.24, p=0.04), which were higher in HSP, and postprandial insulin, which was smaller in HSP (ηp²=0.27, p=0.03). Continuous analyses replicated postprandial insulin response. Compared with OSP, HSP reported numerically higher binge-eating frequency (ηp²=0.04), over-eating frequency (ηp²=0.06), and carbohydrate intake (ηp²=0.14), and they exhibited numerically smaller postprandial glucose AUC (ηp²=0.16). Sweet taste preference may have implications for glucose regulation, binge-eating frequency, and nutrient intake in BED.

Quality of randomized controlled trials in eating disorder prevention

OBJECTIVE

To investigate the quality of randomized controlled trials (RCTs) of eating disorder prevention.

METHOD

A systematic literature search was conducted in Medline, PsycINFO, Embase, Scopus, and the Cochrane Collaboration Library to January 2016. Studies were included if they were RCTs that tested an eating disorder prevention program. We identified 96 studies with a total 15,350 participants (91% female, M age = 17 years) and rated quality with the Quality Rating Scale (QRS; Moncrieff et al., 2001).

RESULTS

The mean QRS score was 62% (SD = 13%). Several standards of quality were not frequently fulfilled (i.e., failed to achieve an optimal rating), for example, power calculation (85%), intent-to-treat analysis (54%), blinding of assessor (75%), representative sample (78%), adequate sample size (75%), and appropriate duration of trial including follow-up (67%). QRS was positively and significantly associated with publication year, number of authors, and PubMed-indexation.

DISCUSSION

Given the majority of eating disorder prevention studies had problems with trial quality, it is recommended that future RCTs follow quality checklists and CONSORT guidelines, that RCTs are registered, and protocols published in advance. In addition, funding bodies are called on to deliver the support needed to ensure that preventions for eating disorders are efficiently and cost-effectively achieved.

Facets of Impulsivity and Compulsivity in Women with Anorexia Nervosa

This study sought to investigate independent associations of impulsivity and compulsivity with eating disorder (ED) symptoms. Women (N = 81) with full or subthreshold Diagnostic and Statistical Manual of Mental Disorders IV anorexia nervosa (AN) completed a semi-structured interview and self-report questionnaires. Multiple regression analyses were conducted using ED symptoms as dependent variables and facets of impulsivity and compulsivity as predictor variables (controlling for body mass index and AN diagnostic subtype). For impulsivity facets, lack of perseverance was uniquely associated with eating concern, shape concern and restraint, whereas negative urgency was uniquely associated with eating concern and frequency of loss of control eating; neither sensation seeking nor lack of premeditation was uniquely associated with any ED variables. Compulsivity was uniquely associated with restraint, eating concern and weight concern. Results support independent associations of impulsivity and compulsivity with ED symptoms in adults with AN, suggesting potential utility in addressing both impulsive and compulsive processes in treatment. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

Nonmedical prescription stimulant use for suppressing appetite and controlling body weight is uniquely associated with more severe eating disorder symptomatology

OBJECTIVE

Nonmedical prescription stimulant use (NPS; i.e., use without a prescription or in ways other than prescribed) to suppress appetite or control weight appears to be associated with eating disorder (ED) symptomatology among college students. However, it remains unknown if this relationship is motive-specific and uniquely related to ED symptomatology. This research examined whether engaging in NPS specifically for appetite/weight-related purposes is associated with ED symptomatology and a unique indicator of more severe symptomatology.

METHOD

A nonclinical sample of college students (N = 668; 79% female) reported eating disorder symptoms via the Eating Pathology Symptoms Inventory and Eating Disorder Examination-Questionnaire, and lifetime history of NPS and corresponding motives.

RESULTS

Binge eating, body dissatisfaction, negative attitudes towards obesity, restricting, purging, and cognitive restraint were reported more frequently by students who endorsed NPS for weight/appetite-related purposes than by those who used for other purposes or denied lifetime NPS. Additionally, NPS for appetite/weight-related purposes was uniquely associated with ED symptomatology after adjusting for gender, lifetime NPS, and past-month binge eating and purging.

DISCUSSION

Engaging in NPS for appetite/weight-related purposes is a unique indicator of ED symptomatology, highlighting the need to query for this behavior among individuals with an ED. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:813-816).

Acute and chronic desensitization of penicillin-allergic patients using oral penicillin

The efficacy, safety and mechanisms of penicillin desensitization were studied in 24 adults and two children with serious infections that required therapy with a beta-lactam drug. Indications for desensitization included debilitating as well as life-endangering infections. Increasing oral doses of phenoxymethyl penicillin were administered at 15-minute intervals to a cumulative dose of 1.3 million units. Parenteral therapy with the beta-lactam drug of choice was instituted at that point. Immunologic complications of desensitization or therapy, ranging from pruritus to serum sickness, occurred in 12 patients. The appearance of gradually worsening wheezing led to abandonment of the procedure in one subject with cystic fibrosis and severe pulmonary disease. The remaining 25 patients were successfully desensitized and received full-dose parenteral therapy. Chronic desensitization was maintained in seven individuals with twice daily oral penicillins for 3 weeks to more than 2 years. No allergic complications of chronic desensitization or recurrent full-dose parenteral therapy were detected. Skin test reactions to one or all penicillin determinants became negative in 11 of 15 patients retested after acute desensitization. Two desensitized patients became skin test negative, remained skin test negative after cessation of desensitization, and tolerated subsequent beta-lactam therapy without allergic reactions or resensitization. The results of this study provide new evidence that acute and chronic penicillin desensitization is useful and an acceptably safe approach and suggest that antigen-specific mast cell desensitization contributes to the protection against anaphylaxis.

Bone scintigraphy in the diagnosis of mastoiditis

Bone scintigraphy has proven utility in the early diagnosis of osteomyelitis, but the authors were unable to find any report of its specific application to mastoiditis. Three cases of mastoiditis are presented in which the bone scan findings predicted the histopathologic findings.

Prospective double-blind evaluation of topical adenine arabinoside in male herpes progenitalis

Thirty-four virologically proven episodes of herpes progenitalis in 32 men were treated in a prospective double-blind study with either adenine arabinoside ointment or an identical-appearing placebo for 7 days. Clinical evaluation and quantitative virological studies were done on days 1, 3, and 8. There was a highly significant correlation between clinical response and quantitative virology. There was no difference in clinical or virological response between drug and control groups. Primary attacks tended to have higher viral excretion over the period of observation. The level of complement-fixing antibody to herpes simplex virus type 2(<1:16 versus >/=1:16) in patients with recurrent disease did not appear to alter the course of viral excretion.

Prospective comparative study of variable dosage and variable frequency regimens for administration of gentamicin

In patients with impaired renal function, careful adjustment of gentamicin dosage is required to achieve therapeutic yet nontoxic concentrations. Two regimens that differ in pharmacodynamic characteristics have been recommended for this purpose: prolonging the intervals between administration of equal doses (variable frequency regimen [VFR]) or administering a loading dose followed at the usual intervals by reduced maintenance doses (variable dosage regimen [VDR]). These regimens were compared in a prospective, randomized study of 20 seriously ill hospitalized patients, 10 on VFR and 10 on VDR. Wide variability in peak serum levels of gentamicin was observed both between patients and in individual patients after separate injections of the same dosage. As predicted by the design of these regimens, the trough serum levels of gentamicin correlated significantly with the serum creatinine concentrations in patients on the VDR but not in patients on the VFR. A gentamicin trough level of >/=4 mug/ml was the only variable among those tested that correlated significantly with development or progression of renal insufficiency during treatment with gentamicin, but such trough levels were observed frequently on both regimens. Whereas this study does not permit a direct comparison of the therapeutic efficacy of VDR and VFR, no difference in the risk of nephrotoxicity with these regimens was observed.