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Witcomb GL, White HJ, Haycraft E, Holley CE, Plateau CR, McLeod CJ. COVID-19 and coping: Absence of previous mental health issues as a potential risk factor for poor wellbeing in females. Dialogues Health 2023; 2:100113. [PMID: 36785729 PMCID: PMC9907791 DOI: 10.1016/j.dialog.2023.100113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 01/24/2023] [Accepted: 02/05/2023] [Indexed: 02/11/2023]
Abstract
COVID-19 has caused unprecedented disruption to everyday life. Unsurprisingly, this has resulted in increased prevalence of poor mental wellbeing. While previous mental health issues have been consistently flagged as a risk factor, the absence of these may also leave individuals vulnerable due to a lack of psychological coping strategies. This study explored the change in symptoms of anxiety, depression, and trauma in 167 females who provided data at four timepoints over the course of the first year of the pandemic. There was a significant effect of time on the extent of the change in depression but, for all wellbeing measures, those with current or previous mental health issues experienced a similar magnitude of change as those with no previous issues. This suggests that low-risk individuals may be faring worse, relatively. Ensuring that this group is not overlooked will be imperative in protecting and re-building the wellbeing of the nation.
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Witcomb GL, Cooper C. 'Show Us a Kiss!': The Everyday Sexual Harassment Experiences of Female Lesbian, Bisexual, and Queer Students. Violence Against Women 2023:10778012231166399. [PMID: 37019434 DOI: 10.1177/10778012231166399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
This study explored the experiences of lesbian, bisexual, and queer (LBQ) students' (N = 9, aged 19-24) of sexual harassment via semistructured interviews. Data were analysed using a thematic analysis. Three overarching themes emerged: (a) the paradox of men's unwanted sexual attention, (b) the negative impact on relationships, and (c) the LGBTQ* community as a refuge. The women reported enduring unwanted heteronormative sexual attention, and heterosexist and homophobic harassment which forced some to conceal their sexuality. Support for the LGBTQ* community was central in developing confidence to call-out harassment. The findings call for the inclusion of LBQ-specific messages in sexual violence awareness and prevention interventions.
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Affiliation(s)
- Gemma L Witcomb
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, LE11 3TU UK
| | - Charlotte Cooper
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, LE11 3TU UK
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3
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Spiliopoulou A, Witcomb GL. An Exploratory Investigation Into Women's Experience of Sexual Harassment in the Workplace. Violence Against Women 2022:10778012221114921. [PMID: 35971324 DOI: 10.1177/10778012221114921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The recent surge in online movements challenging the culture of silence surrounding sexual harassment has created new spaces for women to share their stories. This research employed a qualitative, exploratory design to study 199 comments on a public online community forum: "What's The Wildest Thing That Happened To You As A Working Woman?". Inductive thematic analysis was performed on the data which resulted in three overarching themes: "a harassment endemic," "the (im)balance of power," and "it's in the culture". Sexual harassment was centered as a normal part of women's workplace experience, as was lack of affirmative action from employers which increased the severity of experiences. Organizations must commit to challenging the structures and individuals that perpetuate unsafe working conditions for women.
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Affiliation(s)
- Ashleigh Spiliopoulou
- School of Sport, Exercise and Health Sciences, 5156Loughborough University, Loughborough, UK
| | - Gemma L Witcomb
- School of Sport, Exercise and Health Sciences, 5156Loughborough University, Loughborough, UK
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4
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McLeod CJ, James LJ, Witcomb GL. Portions selected to stave off hunger are reduced when food is presented in an 'unusual' food-to-mealtime context: An implication for implicit satiety drivers. Appetite 2022; 178:106275. [PMID: 35964794 DOI: 10.1016/j.appet.2022.106275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 08/01/2022] [Accepted: 08/08/2022] [Indexed: 11/02/2022]
Abstract
Research suggests that the role of expected satiety in influencing portion-size selection is reduced when food is presented in unusual food-to-mealtime contexts; however, the underlying mechanism has not been explored. Other research has revealed that different implicit satiety drivers (e.g., to stop momentary hunger or obtain complete fullness) are associated with different perceived levels of stomach fullness, portion-size selections and can change on instruction. The current study explored whether changes in expected satiety and ideal portions in congruous vs incongruous contexts can be explained by changes in implicit satiety drivers. Another aim was to investigate a previous exploratory finding suggesting that portions selected to stave off hunger are reduced when foods are presented in unusual food-to-mealtime contexts. At two trials (breakfast/lunch), participants (n = 40) selected a portion of typical lunch (pasta) and breakfast (porridge) foods via a psychophysical computer-based method 1) to stave off hunger for 5 h, and 2) as an ideal portion. Participants also indicated their perceived level of stomach fullness associated with 1) each portion, and 2) five implicit satiety drivers. Results revealed that a smaller average portion was selected to stave off hunger in incongruous (vs congruous) food-to-mealtime contexts (531 ± 229 vs 575 ± 236 kcal) (p = 0.008). This suggests that expected satiety is influenced by momentary context; foods are perceived to be more satiating when consumed in unusual (vs usual) contexts. Results also showed that implicit satiety drivers are malleable in regard to the portion size associated with a perceived level of stomach fullness and that this can vary contextually. These findings provide initial evidence to explain the psychological mechanism underlying the contextual differences observed in portion-size selections. Future work should explore longer-term impacts of consuming foods in unusual contexts.
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Affiliation(s)
- C J McLeod
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, LE11 3TU, UK.
| | - L J James
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, LE11 3TU, UK
| | - G L Witcomb
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, LE11 3TU, UK
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McLeod CJ, Mycock GMW, Twells A, James LJ, Brunstrom JM, Witcomb GL. Current appetite influences relative differences in the expected satiety of foods for momentary, but not hypothetical, expected satiety assessments. Appetite 2022; 178:106159. [PMID: 35809705 DOI: 10.1016/j.appet.2022.106159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 06/21/2022] [Accepted: 06/29/2022] [Indexed: 11/02/2022]
Abstract
Research has shown that expected satiety is highly associated with portion-size selection and can vary (kcal-for-kcal) significantly between foods. However, research has not adequately investigated whether current appetite influences relative differences in the expected satiety of foods. This is important to explore to better understand how current motivational state influences food choice and portion selection. This study used 'hypothetical' and 'momentary' expected-satiety assessments to understand whether methods requiring a reflection on current motivational state [momentary] versus more hypothetical considerations when assessing expected satiety can influence the interpretation of results. It was hypothesised that current appetite would only influence relative differences in expected satiety between foods for momentary, but not hypothetical, expected satiety assessments. Participants (n = 54) were shown images of twelve foods, once when hungry and once when full. In each case, they selected a portion for each food to 1) match the expected satiety of a fixed-portion 'standard' food [hypothetical], and 2) stave off hunger until their next meal [momentary]. Results showed that the relative between-food comparison of expected satiety was stable for hypothetical (p=.73) but not momentary assessments (p<.001) suggesting that while current motivational state may influence food choice and portion selection in the moment, more generalised comparisons of the satiating abilities of foods (learned over a longer period) remain stable. This is important 1) for methods in future studies, as immediate dietary intake does not appear to influence hypothetical expected satiety, thus dietary control is not necessary before participants undertake these assessments, and 2) as it confirms that difficulties associated with dietary regulation may not be due to inaccurate hypothetical judgements about foods, but instead appear to be influenced by contextual nuances that occur in the moment.
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Affiliation(s)
- C J McLeod
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, LE11 3TU, UK.
| | - G M W Mycock
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, LE11 3TU, UK
| | - A Twells
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, LE11 3TU, UK
| | - L J James
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, LE11 3TU, UK
| | - J M Brunstrom
- Nutrition and Behaviour Unit, School of Psychological Science, University of Bristol, Bristol, BS8 1TU, UK
| | - G L Witcomb
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, LE11 3TU, UK
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6
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Knott-Fayle G, Peel E, Witcomb GL. Prejudice in ‘inclusive’ spaces: Cisgenderist collusion in the interview context. Feminism & Psychology 2022. [DOI: 10.1177/09593535211063263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Feminist reflexivity aims to (re)consider and challenge power differentials that exist in the research process. This activity is well represented in, for example, research into heterosexism. In this article we expand feminist reflexive practice in relation to cisgenderism through a (re)examination of interview transcripts conducted by a cisgender researcher on the topic of cisgenderism in media representations of trans and intersex sportspeople. Drawing on interviews with 18 cisgender and trans and non-binary participants, we analyse three forms of researcher collusion in cisgenderism, namely: 1) perpetuating cisgenderism in the selection of media materials; 2) assuming trans women are the referent; and 3) disunifying assumptions about trans sportspeople. This reflexive analysis is discussed with regard to how analytical insights can be generated into the operation and functioning of prejudice. In so doing, we further the conception of prejudice as a ubiquitous and latent activity in research practices.
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Harper J, O'Donnell E, Sorouri Khorashad B, McDermott H, Witcomb GL. How does hormone transition in transgender women change body composition, muscle strength and haemoglobin? Systematic review with a focus on the implications for sport participation. Br J Sports Med 2021; 55:865-872. [PMID: 33648944 PMCID: PMC8311086 DOI: 10.1136/bjsports-2020-103106] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2021] [Indexed: 12/18/2022]
Abstract
Objectives We systemically reviewed the literature to assess how long-term testosterone suppressing gender-affirming hormone therapy influenced lean body mass (LBM), muscular area, muscular strength and haemoglobin (Hgb)/haematocrit (HCT). Design Systematic review. Data sources Four databases (BioMed Central, PubMed, Scopus and Web of Science) were searched in April 2020 for papers from 1999 to 2020. Eligibility criteria for selecting studies Eligible studies were those that measured at least one of the variables of interest, included transwomen and were written in English. Results Twenty-four studies were identified and reviewed. Transwomen experienced significant decreases in all parameters measured, with different time courses noted. After 4 months of hormone therapy, transwomen have Hgb/HCT levels equivalent to those of cisgender women. After 12 months of hormone therapy, significant decreases in measures of strength, LBM and muscle area are observed. The effects of longer duration therapy (36 months) in eliciting further decrements in these measures are unclear due to paucity of data. Notwithstanding, values for strength, LBM and muscle area in transwomen remain above those of cisgender women, even after 36 months of hormone therapy. Conclusion In transwomen, hormone therapy rapidly reduces Hgb to levels seen in cisgender women. In contrast, hormone therapy decreases strength, LBM and muscle area, yet values remain above that observed in cisgender women, even after 36 months. These findings suggest that strength may be well preserved in transwomen during the first 3 years of hormone therapy.
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Affiliation(s)
- Joanna Harper
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Emma O'Donnell
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | | | - Hilary McDermott
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Gemma L Witcomb
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
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8
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Barutcu A, Briasco E, Moon J, Stensel DJ, King JA, Witcomb GL, James LJ. Planned morning aerobic exercise in a fasted state increases energy intake in the preceding 24 h. Eur J Nutr 2021; 60:3387-3396. [PMID: 33620552 PMCID: PMC8354893 DOI: 10.1007/s00394-021-02501-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 01/22/2021] [Indexed: 12/18/2022]
Abstract
Purpose We previously observed increased energy intake (EI) at the meal before planned afternoon exercise, but the proximity of the meal to exercise might have reduced the scale of the pre-exercise anticipatory eating. Therefore, this study examined EI in the 24 h before fasted morning exercise. Methods Fourteen males, experienced with gym-based aerobic exercise (age 25 ± 5 years, BMI 23.8 ± 2.5 kg/m2), completed counterbalanced exercise (EX) and resting (REST) trials. On day 1, subjects were told the following morning’s activity (EX/REST), before eating ad-libitum laboratory-based breakfast and lunch meals and a home-based afternoon/evening food pack. The following morning, subjects completed 30-min cycling and 30-min running (EX; 3274 ± 278 kJ) or 60-min supine rest (REST; 311 ± 34 kJ) fasted. Appetite was measured periodically, and EI quantified. Results Afternoon/evening EI (EX 7371 ± 2176 kJ; REST 6437 ± 2070 kJ; P = 0.017) and total 24-h EI (EX 14,055 ± 3672 kJ; REST 12,718 ± 3379 kJ; P = 0.011) were greater during EX, with no difference between trials at breakfast (P = 0.761) or lunch (P = 0.071). Relative EI (EI minus energy expended through EX/REST) was lower in EX (EX 10,781 ± 3539 kJ; REST 12,407 ± 3385 kJ; P = 0.004). Conclusion This study suggests planned fasted aerobic exercise increases EI during the preceding afternoon/evening, precipitating a ~ 10% increase in EI in the preceding 24-h. However, this increase did not fully compensate for energy expended during exercise; meaning exercise induced an acute negative energy balance.
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Affiliation(s)
- Asya Barutcu
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, LE11 3TU, UK
| | - Elizabeth Briasco
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, LE11 3TU, UK
| | - Jake Moon
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, LE11 3TU, UK
| | - David J Stensel
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, LE11 3TU, UK
| | - James A King
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, LE11 3TU, UK
| | - Gemma L Witcomb
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, LE11 3TU, UK
| | - Lewis J James
- School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, LE11 3TU, UK.
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9
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Crowder RC, Witcomb GL, Haycraft E. Understanding UK Primary School Teachers’ Motivations and Perspectives Around School Fruit and Vegetable Gardening. Appetite 2021. [DOI: 10.1016/j.appet.2020.104940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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10
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Aldridge Z, Patel S, Guo B, Nixon E, Pierre Bouman W, Witcomb GL, Arcelus J. Long‐term effect of gender‐affirming hormone treatment on depression and anxiety symptoms in transgender people: A prospective cohort study. Andrology 2020; 9:1808-1816. [DOI: 10.1111/andr.12884] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 07/27/2020] [Accepted: 08/05/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Zoë Aldridge
- Faculty of Medicine and Health Sciences Institute of Mental Health University of Nottingham Nottingham UK
- School of Sport, Exercise and Health Sciences Loughborough University Loughborough UK
| | - Shireen Patel
- Faculty of Medicine and Health Sciences Institute of Mental Health University of Nottingham Nottingham UK
| | - Boliang Guo
- Faculty of Medicine and Health Sciences Institute of Mental Health University of Nottingham Nottingham UK
| | - Elena Nixon
- Faculty of Medicine and Health Sciences Institute of Mental Health University of Nottingham Nottingham UK
| | - Walter Pierre Bouman
- Faculty of Medicine and Health Sciences Institute of Mental Health University of Nottingham Nottingham UK
- Nottingham Centre for Transgender Health Nottingham UK
| | | | - Jon Arcelus
- Faculty of Medicine and Health Sciences Institute of Mental Health University of Nottingham Nottingham UK
- Nottingham Centre for Transgender Health Nottingham UK
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11
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Witcomb GL, Claes L, Bouman WP, Nixon E, Motmans J, Arcelus J. Experiences and Psychological Wellbeing Outcomes Associated with Bullying in Treatment-Seeking Transgender and Gender-Diverse Youth. LGBT Health 2019; 6:216-226. [DOI: 10.1089/lgbt.2018.0179] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
- Gemma L. Witcomb
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Laurence Claes
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | | | - Elena Nixon
- Faculty of Medicine and Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Joz Motmans
- Centre for Sexology and Gender, Ghent University Hospital, Ghent, Belgium
| | - Jon Arcelus
- The Nottingham Centre for Transgender Health, Nottingham, United Kingdom
- Faculty of Medicine and Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
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12
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Barutcu A, Witcomb GL, James LJ. Anticipation of aerobic exercise increases planned energy intake for a post-exercise meal. Appetite 2019; 138:198-203. [DOI: 10.1016/j.appet.2019.03.035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 03/28/2019] [Accepted: 03/28/2019] [Indexed: 01/30/2023]
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13
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Barutcu A, Taylor S, McLeod C, Witcomb GL, James LJ. Influence of exercise on pre- and post-exercise food intake. Appetite 2018. [DOI: 10.1016/j.appet.2018.05.156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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14
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Witcomb GL, Bouman WP, Claes L, Brewin N, Crawford JR, Arcelus J. Levels of depression in transgender people and its predictors: Results of a large matched control study with transgender people accessing clinical services. J Affect Disord 2018; 235:308-315. [PMID: 29665513 DOI: 10.1016/j.jad.2018.02.051] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 01/12/2018] [Accepted: 02/16/2018] [Indexed: 01/04/2023]
Abstract
BACKGROUND Depression is a serious disorder which significantly impacts wellbeing and quality of life. Studies exploring mental wellbeing in the transgender population are mostly limited by small, non-homogenous samples and lack of matched controls. This study aimed to address these limitations and explore depression rates in a large sample of transgender people, compared with matched controls from the general population, as well as factors predicting depression in those taking cross-sex hormone treatment (CHT) compared to those not. METHODS Transgender individuals (n = 913) completed a measure of depression, measures which predict psychopathology (self-esteem, victimization, social support, interpersonal problems), and information regarding CHT use. Participants were matched by age and experienced gender with adults from the general population who had completed the measure of depression. RESULTS Individuals were categorized as having no, possible or probable depressive disorder. Transgender individuals not on CHT had a nearly four-fold increased risk of probable depressive disorder, compared to controls. Older age, lower self-esteem, poorer interpersonal function and less social support predicted depressive disorder. Use of CHT was associated with less depression. LIMITATIONS Participants were attending a national gender identity service and therefore represent only a sub-group of transgender people. Due to the cross-sectional design, longitudinal research is required to fully confirm the finding that CHT use reduces depression. CONCLUSION This study confirms that non-treated transgender individuals have an increased risk of a depressive disorder. Interventions offered alongside gender affirming treatment to develop interpersonal skills, increase self-esteem and improve social support may reduce depression and prepare individuals for a more successful transition.
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Affiliation(s)
- Gemma L Witcomb
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Walter Pierre Bouman
- Nottingham Centre for Transgender Health, 12 Broad Street, Nottingham NG1 3AL, United Kingdom.
| | - Laurence Claes
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium; Faculty of Medicine and Health Sciences (CAPRI), University of Antwerp, Antwerp, Belgium
| | - Nicola Brewin
- Nottingham Centre for Transgender Health, 12 Broad Street, Nottingham NG1 3AL, United Kingdom
| | - John R Crawford
- School of Psychology, University of Aberdeen, Aberdeen, United Kingdom
| | - Jon Arcelus
- Nottingham Centre for Transgender Health, 12 Broad Street, Nottingham NG1 3AL, United Kingdom; Institute of Mental Health, Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, United Kingdom
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15
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Thorne N, Witcomb GL, Nieder T, Nixon E, Yip A, Arcelus J. A comparison of mental health symptomatology and levels of social support in young treatment seeking transgender individuals who identify as binary and non-binary. INT J TRANSGENDERISM 2018; 20:241-250. [PMID: 32999610 PMCID: PMC6830974 DOI: 10.1080/15532739.2018.1452660] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Background : Previous research has consistently reported high rates of mental health symptomatology and lower social support in young treatment seeking transgender individuals. However, these studies have failed to distinguish between transgender people who identify within the gender binary and those who identify as non-binary. Aims : This study aimed to compare levels of mental health symptomatology (anxiety, depression, and non-suicidal self-injury behavior) and social support of treatment seeking non-binary transgender young individuals with those self-identified as binary transgender young individuals. All participants attended a national transgender health service in the UK during a 2-year period. Measures : Age and gender identity descriptors were collected, as well as clinical measures of anxiety and depression (Hospital Anxiety and Depression Scale), self-esteem (The Rosenberg Self-Esteem Scale), non-suicidal self-injury (Non-Suicidal Self-Injury: Treatment Related), and social support (Multidimensional Scale of Perceived Social Support). Results : A total of 388 young people, aged 16-25 years, agreed participation; 331 (85.3%) identified as binary and 57 (14.7%) as non-binary. Analysis of the data showed the non-binary group experienced significantly more anxiety and depression and had significantly lower self-esteem than the binary group. There were no significant differences between groups in the likelihood of engaging in non-suicidal self-injury behavior or levels of social support. Conclusions : Non-binary identifying treatment seeking transgender youth are at increased risk of developing anxiety, depression, and low self-esteem compared to binary transgender youth. This may reflect the even greater barriers and feelings of discrimination that may be faced by those whose identity does not fit the notion of binary gender that is pervasive in how society views both cis- and transgender populations.
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Affiliation(s)
- Nat Thorne
- School of Medicine, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | | | - Timo Nieder
- Department and Outpatient Clinic of Sex Research and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Elena Nixon
- School of Medicine, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Andrew Yip
- School of Sociology and Social Policy, University of Nottingham, Nottigham, United Kingdom
| | - Jon Arcelus
- Faculty of Medicine and Health Sciences, Institute of Mental health, University of Nottingham, Nottingham, United Kingdom
- Nottinghamshire Healthcare NHS Trust, Nottingham Centre for Gender Dysphoria, Nottingham, United Kingdom
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16
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Schalla SC, Witcomb GL, Haycraft E. Body Shape and Weight Loss as Motivators for Breastfeeding Initiation and Continuation. Int J Environ Res Public Health 2017; 14:ijerph14070754. [PMID: 28696385 PMCID: PMC5551192 DOI: 10.3390/ijerph14070754] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 07/04/2017] [Accepted: 07/06/2017] [Indexed: 11/16/2022]
Abstract
Breastfeeding rates in the UK are low. Efforts to promote breastfeeding typically include the known health benefits for mother and child, many of which are not immediate. Gaining immediate benefits can be effective motivators of behaviour. Body-related changes resulting from breastfeeding could be an immediate benefit. This study explored breastfeeding mothers’ reports of body-related changes as benefits of breastfeeding. Mothers (N = 182) who currently, or had recently, breastfed an infant completed a survey detailing their infant feeding choices and the perceived benefits of breastfeeding on their bodies. Half of the mothers felt that breastfeeding had a positive effect on their body. Benefits were grouped into five themes: (1) Returning to pre-pregnancy body shape; (2) Health benefits; (3) Physical benefits; (4) Eating benefits; (5) Psychological benefits. These themes highlight the numerous body-related benefits that mothers identified as resulting from breastfeeding and suggest that immediate, personal, and appearance-related gains of breastfeeding are highly valued. These findings indicate that interventions would likely benefit from emphasising the more immediate physical and psychological benefits of breastfeeding, alongside the health and bonding benefits, as a way to promote breastfeeding initiation and continuation in more women. This may be particularly effective for groups such as young mothers, where breastfeeding rates are low and whose emphasis on body image may be greater.
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Affiliation(s)
- Sophie C Schalla
- School of Sport, Exercise & Health Sciences, Loughborough University, Leicestershire LE11 3TU, UK.
| | - Gemma L Witcomb
- School of Sport, Exercise & Health Sciences, Loughborough University, Leicestershire LE11 3TU, UK.
| | - Emma Haycraft
- School of Sport, Exercise & Health Sciences, Loughborough University, Leicestershire LE11 3TU, UK.
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17
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Affiliation(s)
- Gemma L. Witcomb
- School of Sport, Exercise and Health Sciences Loughborough University Loughborough, UK
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Beek TF, Cohen-Kettenis PT, Bouman WP, de Vries ALC, Steensma TD, Witcomb GL, Arcelus J, Richards C, De Cuypere G, Kreukels BPC. Gender Incongruence of Childhood: Clinical Utility and Stakeholder Agreement with the World Health Organization's Proposed ICD-11 Criteria. PLoS One 2017; 12:e0168522. [PMID: 28081569 PMCID: PMC5233419 DOI: 10.1371/journal.pone.0168522] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Accepted: 12/04/2016] [Indexed: 11/18/2022] Open
Abstract
The World Health Organization (WHO) is revising the tenth version of the International Classification of Diseases and Related Health Problems (ICD-10). This includes a reconceptualization of the definition and positioning of Gender Incongruence of Childhood (GIC). This study aimed to: 1) collect the views of transgender individuals and professionals regarding the retention of the diagnosis; 2) see if the proposed GIC criteria were acceptable to transgender individuals and health care providers; 3) compare results between two countries with two different healthcare systems to see if these differences influence opinions regarding the GIC diagnosis; and 4) determine whether healthcare providers from high-income countries feel that the proposed criteria are clinically useful and easy to use. A total of 628 participants were included in the study: 284 from the Netherlands (NL; 45.2%), 8 from Flanders (Belgium; 1.3%), and 336 (53.5%) from the United Kingdom (UK). Most participants were transgender people (or their partners/relatives; TG) (n = 522), 89 participants were healthcare providers (HCPs) and 17 were both HCP and TG individuals. Participants completed an online survey developed for this study. Overall, the majority response from transgender participants (42.9%) was that if the diagnosis would be removed from the mental health chapter it should also be removed from the ICD-11 completely, while 33.6% thought it should remain in the ICD-11. Participants were generally satisfied with other aspects of the proposed ICD-11 GIC diagnosis: most TG participants (58.4%) thought the term Gender Identity Disorder should change, and most thought Gender Incongruence was an improvement (63.0%). Furthermore, most participants (76.1%) did not consider GIC to be a psychiatric disorder and placement in a separate chapter dealing with Gender and Sexual Health (the majority response in the NL and selected by 37.5% of the TG participants overall) or as a Z-code (the majority response in the UK and selected by 26.7% of the TG participants overall) would be preferable. In the UK, the majority response (35.8%) was that narrowing the GIC diagnosis was an improvement, while the NL majority response (49.5%) was that this was not an improvement. Although generally the results from HCPs were in line with the results from TG participants some differences were found. This study suggests that, although in an ideal world a diagnosis is not welcomed, several participants felt the diagnosis should not be removed. This is likely due to concerns about restricting access to reimbursed healthcare. The choice for positioning of a diagnosis of GIC within the ICD-11 was as a separate chapter dealing with symptoms and/or disorders regarding sexual and gender health. This was the overall first choice for NL participants and second choice for UK participants, after the use of a Z-code. The difference reflects that in the UK, Z-codes carry no negative implications for reimbursement of treatment costs. These findings highlight the challenges faced by the WHO in their attempt to integrate research findings from different countries, with different cultures and healthcare systems in their quest to create a manual that is globally applicable.
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Affiliation(s)
- Titia F. Beek
- Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, The Netherlands
- Department of Medical Psychology, VU University Medical Center, Amsterdam, The Netherlands
- * E-mail: (TFB); (BPCK)
| | - Peggy T. Cohen-Kettenis
- Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, The Netherlands
- Department of Medical Psychology, VU University Medical Center, Amsterdam, The Netherlands
| | - Walter P. Bouman
- Nottingham Centre for Gender Dysphoria, Nottingham, United Kingdom
| | - Annelou L. C. de Vries
- Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, The Netherlands
- Department of Child and Adolescent Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| | - Thomas D. Steensma
- Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, The Netherlands
- Department of Medical Psychology, VU University Medical Center, Amsterdam, The Netherlands
| | - Gemma L. Witcomb
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Jon Arcelus
- Nottingham Centre for Gender Dysphoria, Nottingham, United Kingdom
- Division of Psychiatry and Applied Psychology, Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, United Kingdom
| | | | - Griet De Cuypere
- Center for Sexology and Gender, Ghent University Hospital, Ghent, Belgium
| | - Baudewijntje P. C. Kreukels
- Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, The Netherlands
- Department of Medical Psychology, VU University Medical Center, Amsterdam, The Netherlands
- * E-mail: (TFB); (BPCK)
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Abstract
Literature has described high levels of mental health problems among trans people, such as depression, resulting in increased levels of non-suicidal self-injury (NSSI) behaviour and suicidality (suicidal thoughts, suicide attempts and suicide rates). With the aim of systematically reviewing the available literature in this field, this study identifies 31 papers that explore the rates of NSSI and suicidality in trans people. From reviewing the literature, it was revealed that trans people have a higher prevalence of NSSI and suicidality compared to the cisgender (non-trans) population. There appear to be some gender differences within these rates, with trans men at a greater risk for NSSI behaviour. Prevalence rates differ depending on the different stages of transition, but they are still overall greater than the cisgender population. The study concludes that trans individuals are at a greater risk of NSSI behaviour and suicidality than the cisgender population, and discusses risk factors and the need to develop effective preventative interventions.
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Affiliation(s)
- Ellen Marshall
- a Nottingham Centre for Gender Dysphoria , Nottingham , UK.,b School of Sport, Exercise, and Health Sciences, Loughborough University , Loughborough , UK
| | - Laurence Claes
- c Faculty of Psychology and Educational Sciences, University of Leuven , Belgium
| | | | - Gemma L Witcomb
- a Nottingham Centre for Gender Dysphoria , Nottingham , UK.,b School of Sport, Exercise, and Health Sciences, Loughborough University , Loughborough , UK
| | - Jon Arcelus
- a Nottingham Centre for Gender Dysphoria , Nottingham , UK.,d Division of Psychiatry and Applied Psychology, Faculty of Medicine & Health Sciences, University of Nottingham , UK
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Beek TF, Cohen-Kettenis PT, Bouman WP, de Vries ALC, Steensma TD, Witcomb GL, Arcelus J, Richards C, Elaut E, Kreukels BPC. Gender Incongruence of Adolescence and Adulthood: Acceptability and Clinical Utility of the World Health Organization's Proposed ICD-11 Criteria. PLoS One 2016; 11:e0160066. [PMID: 27776134 PMCID: PMC5077108 DOI: 10.1371/journal.pone.0160066] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 07/13/2016] [Indexed: 11/19/2022] Open
Abstract
The World Health Organization (WHO) is currently updating the tenth version of their diagnostic tool, the International Classification of Diseases (ICD, WHO, 1992). Changes have been proposed for the diagnosis of Transsexualism (ICD-10) with regard to terminology, placement and content. The aim of this study was to gather the opinions of transgender individuals (and their relatives/partners) and clinicians in the Netherlands, Flanders (Belgium) and the United Kingdom regarding the proposed changes and the clinical applicability and utility of the ICD-11 criteria of 'Gender Incongruence of Adolescence and Adulthood' (GIAA). A total of 628 participants were included in the study: 284 from the Netherlands (45.2%), 8 from Flanders (Belgium) (1.3%), and 336 (53.5%) from the UK. Most participants were transgender people (or their partners/relatives) (n = 522), 89 participants were healthcare providers (HCPs) and 17 were both healthcare providers and (partners/relatives of) transgender people. Participants completed an online survey developed for this study. Most participants were in favor of the proposed diagnostic term of 'Gender Incongruence' and thought that this was an improvement on the ICD-10 diagnostic term of 'Transsexualism'. Placement in a separate chapter dealing with Sexual- and Gender-related Health or as a Z-code was preferred by many and only a small number of participants stated that this diagnosis should be excluded from the ICD-11. In the UK, most transgender participants thought there should be a diagnosis related to being trans. However, if it were to be removed from the chapter on "psychiatric disorders", many transgender respondents indicated that they would prefer it to be removed from the ICD in its entirety. There were no large differences between the responses of the transgender participants (or their partners and relatives) and HCPs. HCPs were generally positive about the GIAA diagnosis; most thought the diagnosis was clearly defined and easy to use in their practice or work. The duration of gender incongruence (several months) was seen by many as too short and required a clearer definition. If the new diagnostic term of GIAA is retained, it should not be stigmatizing to individuals. Moving this diagnosis away from the mental and behavioral chapter was generally supported. Access to healthcare was one area where retaining a diagnosis seemed to be of benefit.
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Affiliation(s)
- Titia F Beek
- Department of Medical Psychology & Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, The Netherlands
| | - Peggy T Cohen-Kettenis
- Department of Medical Psychology & Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, The Netherlands
| | - Walter P Bouman
- Nottingham Centre for Gender Dysphoria, Nottingham, United Kingdom
| | - Annelou L C de Vries
- Department of Medical Psychology & Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, The Netherlands
| | - Thomas D Steensma
- Department of Medical Psychology & Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, The Netherlands
| | - Gemma L Witcomb
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Jon Arcelus
- Nottingham Centre for Gender Dysphoria, Nottingham, United Kingdom
- Division of Psychiatry and Applied Psychology, Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, United Kingdom
| | | | - Els Elaut
- Center for Sexology and Gender Problems, Ghent University Hospital, Ghent, Belgium
| | - Baudewijntje P C Kreukels
- Department of Medical Psychology & Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, The Netherlands
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Arcelus J, Claes L, Witcomb GL, Marshall E, Bouman WP. Risk Factors for Non-Suicidal Self-Injury Among Trans Youth. J Sex Med 2016; 13:402-12. [PMID: 26944465 DOI: 10.1016/j.jsxm.2016.01.003] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 01/01/2016] [Accepted: 01/10/2016] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Previous research has reported high levels of non-suicidal self-injury (NSSI) in trans populations and younger age has been identified as a risk factor. AIMS To explore the prevalence of NSSI in a large group of young trans people and to identify risk factors for this group. MAIN OUTCOME MEASURES Sociodemographic variables and measurements of NSSI (Self-Injury Questionnaire), psychopathology (Symptom Checklist-90-Revised), self-esteem (Rosenberg Self-Esteem Scale), victimization (Experiences of Transphobia Scale), interpersonal functioning (Inventory of Interpersonal Problems), and social support (Multidimensional Scale of Perceived Social Support). METHODS Two hundred sixty-eight young people attending a national gender clinic completed questionnaires assessing presence and frequency of NSSI and levels of general psychopathology, depression, anxiety, interpersonal problems, self-esteem, social support, transphobia, and information on hormone treatment. RESULTS A lifetime presence of NSSI was identified in 46.3% of patients and 28.73% reported currently engaging in NSSI (within at least the past few months). Analyses showed that those with a lifetime presence of NSSI had significantly greater general psychopathology, lower self-esteem, had suffered more transphobia, and experienced greater interpersonal problems than those without NSSI. Findings were similar when comparing current with non-current NSSI. Overall, natal male patients reported less social support than natal female patients, but current NSSI was more common in natal female patients. Regression analyses confirmed that natal female gender and greater general psychopathology predicted current and lifetime NSSI. Further analyses confirmed that general psychopathology itself could be predicted by transphobic experiences, low self-esteem, and interpersonal problems, but not by the use of cross-sex hormones. CONCLUSION These findings confirm that NSSI is common in trans youth and emphasize the need for interventions that decrease transphobia, increase social support, and help trans youth navigate their relationships with others to decrease psychopathology and NSSI.
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Affiliation(s)
- Jon Arcelus
- Nottingham Centre for Gender Dysphoria, Nottingham, UK; Division of Psychiatry and Applied Psychology, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK.
| | - Laurence Claes
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium; Faculty of Medicine and Health Sciences (CAPRI), University of Antwerp, Antwerp, Belgium
| | - Gemma L Witcomb
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, UK
| | - Ellen Marshall
- Nottingham Centre for Gender Dysphoria, Nottingham, UK; School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, UK
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Bouman WP, Davey A, Meyer C, Witcomb GL, Arcelus J. Predictors of psychological well-being among treatment seeking transgender individuals. Sexual and Relationship Therapy 2016. [DOI: 10.1080/14681994.2016.1184754] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Witcomb GL, Bouman WP, Brewin N, Richards C, Fernandez-Aranda F, Arcelus J. Body Image Dissatisfaction and Eating-Related Psychopathology in Trans Individuals: A Matched Control Study. Eur Eat Disorders Rev 2015; 23:287-93. [DOI: 10.1002/erv.2362] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 02/24/2015] [Accepted: 03/27/2015] [Indexed: 12/25/2022]
Affiliation(s)
- Gemma L. Witcomb
- School of Sport, Exercise and Health Sciences; Loughborough University; Loughborough UK
| | - Walter Pierre Bouman
- Nottingham Centre for Gender Dysphoria; Nottinghamshire Healthcare NHS Foundation Trust; Nottingham UK
| | - Nicola Brewin
- Leicestershire Adult Eating Disorder Service; Glenfield Hospital; Leicester UK
| | - Christina Richards
- Nottingham Centre for Gender Dysphoria; Nottinghamshire Healthcare NHS Foundation Trust; Nottingham UK
- Charing Cross Gender Identity Clinic; London UK
| | - Fernando Fernandez-Aranda
- Department of Psychiatry; University Hospital of Bellvitge-IDIBELL and CIBER Fisiopatología de la Obesidad y Nutrición CIBERObn; Barcelona Spain
| | - Jon Arcelus
- School of Sport, Exercise and Health Sciences; Loughborough University; Loughborough UK
- Nottingham Centre for Gender Dysphoria; Nottinghamshire Healthcare NHS Foundation Trust; Nottingham UK
- Leicestershire Adult Eating Disorder Service; Glenfield Hospital; Leicester UK
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Moragas L, Granero R, Stinchfield R, Fernández-Aranda F, Fröberg F, Aymamí N, Gómez-Peña M, Fagundo AB, Islam MA, del Pino-Gutiérrez A, Agüera Z, Savvidou LG, Arcelus J, Witcomb GL, Sauchelli S, Menchón JM, Jiménez-Murcia S. Comparative analysis of distinct phenotypes in gambling disorder based on gambling preferences. BMC Psychiatry 2015; 15:86. [PMID: 25886577 PMCID: PMC4406168 DOI: 10.1186/s12888-015-0459-0] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Accepted: 03/26/2015] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Studies examining gambling preferences have identified the importance of the type of gambling practiced on distinct individual profiles. The objectives were to compare clinical, psychopathological and personality variables between two different groups of individuals with a gambling disorder (strategic and non-strategic gamblers) and to evaluate the statistical prediction capacity of these preferences with respect to the severity of the disorder. METHOD A total sample of 2010 treatment-seeking patients with a gambling disorder participated in this stand-alone study. All were recruited from a single Pathological Gambling Unit in Spain (1709 strategic and 301 non-strategic gamblers). The design of the study was cross-sectional and data were collected at the start of treatment. Data was analysed using logistic regression for binary outcomes and analysis of variance (ANOVA) for quantitative responses. RESULTS There were significant differences in several socio-demographic and clinical variables, as well as in personality traits (novelty seeking and cooperativeness). Multiple regression analysis showed harm avoidance and self-directedness were the main predictors of gambling severity and psychopathology, while age at assessment and age of onset of gambling behaviour were predictive of gambling severity. Strategic gambling (as opposed to non-strategic) was significantly associated with clinical outcomes, but the effect size of the relationships was small. CONCLUSIONS It is possible to identify distinct phenotypes depending on the preference of gambling. While these phenotypes differ in relation to the severity of the gambling disorder, psychopathology and personality traits, they can be useful from a clinical and therapeutic perspective in enabling risk factors to be identified and prevention programs targeting specific individual profiles to be developed.
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Affiliation(s)
- Laura Moragas
- Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELL, c/ Feixa Llarga s/n, 08907 L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Roser Granero
- Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (Spain), Barcelona, Spain. .,Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Randy Stinchfield
- Department of Psychiatry, University of Minnesota Medical School, Minnesota, USA.
| | - Fernando Fernández-Aranda
- Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELL, c/ Feixa Llarga s/n, 08907 L'Hospitalet de Llobregat, Barcelona, Spain. .,Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (Spain), Barcelona, Spain. .,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain.
| | - Frida Fröberg
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
| | - Neus Aymamí
- Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELL, c/ Feixa Llarga s/n, 08907 L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Mónica Gómez-Peña
- Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELL, c/ Feixa Llarga s/n, 08907 L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Ana B Fagundo
- Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELL, c/ Feixa Llarga s/n, 08907 L'Hospitalet de Llobregat, Barcelona, Spain. .,Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (Spain), Barcelona, Spain.
| | - Mohammed A Islam
- Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELL, c/ Feixa Llarga s/n, 08907 L'Hospitalet de Llobregat, Barcelona, Spain. .,Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (Spain), Barcelona, Spain.
| | - Amparo del Pino-Gutiérrez
- Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELL, c/ Feixa Llarga s/n, 08907 L’Hospitalet de Llobregat, Barcelona, Spain ,Departament d’Infermeria de Salut Pública, Salut Mental i Maternoinfantil, Escola Universitària d’Infermeria, Universitat de Barcelona, Barcelona, Spain
| | - Zaida Agüera
- Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELL, c/ Feixa Llarga s/n, 08907 L'Hospitalet de Llobregat, Barcelona, Spain. .,Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (Spain), Barcelona, Spain.
| | - Lamprini G Savvidou
- Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELL, c/ Feixa Llarga s/n, 08907 L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Jon Arcelus
- Leicester Eating Disorders Service, Leicester General Hospital, Leicester, UK.
| | - Gemma L Witcomb
- Leicester Eating Disorders Service, Leicester General Hospital, Leicester, UK.
| | - Sarah Sauchelli
- Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELL, c/ Feixa Llarga s/n, 08907 L'Hospitalet de Llobregat, Barcelona, Spain.
| | - José M Menchón
- Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELL, c/ Feixa Llarga s/n, 08907 L'Hospitalet de Llobregat, Barcelona, Spain. .,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain. .,CIBER Salud Mental (CIBERSAM), Instituto Carlos III, Barcelona, Spain.
| | - Susana Jiménez-Murcia
- Pathological Gambling Unit, Department of Psychiatry, Bellvitge University Hospital-IDIBELL, c/ Feixa Llarga s/n, 08907 L'Hospitalet de Llobregat, Barcelona, Spain. .,Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (Spain), Barcelona, Spain. .,Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain.
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Witcomb GL, Arcelus J, Chen J. Can cognitive dissonance methods developed in the West for combatting the 'thin ideal' help slow the rapidly increasing prevalence of eating disorders in non-Western cultures? Shanghai Arch Psychiatry 2014; 25:332-40. [PMID: 24991176 PMCID: PMC4054580 DOI: 10.3969/j.issn.1002-0829.2013.06.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Accepted: 10/18/2013] [Indexed: 11/18/2022]
Abstract
SUMMARY Eating disorders are common, life-threatening conditions in Western countries, but until relatively recently they were regarded as uncommon in non-Western cultures. However, the prevalence of eating disorders in many of the more affluent non-Western countries is rising rapidly as community members, particularly young women, internalize the 'thin ideal' that has been widely promoted by the international media. This review discusses the factors involved in the development of eating disorders in non-Western settings with a particular emphasis on the influences of urbanization, modernization, Westernization, and the resulting changes in women's roles. The cognitive dissonance programs developed in Western countries that have proven successful in countering the negative effects of the thin idea are described and their potential application to East Asia and other non-Western countries are discussed.
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Affiliation(s)
- Gemma L Witcomb
- Loughborough University Centre for Research into Eating Disorders, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK ; Leicester Eating Disorder Service, Bennion Centre, Leicester Glenfield Hospital, Leicester, UK
| | - Jon Arcelus
- Loughborough University Centre for Research into Eating Disorders, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK ; Leicester Eating Disorder Service, Bennion Centre, Leicester Glenfield Hospital, Leicester, UK ; Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PRC
| | - Jue Chen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PRC
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Arcelus J, Witcomb GL, Mitchell A. Prevalence of eating disorders amongst dancers: a systemic review and meta-analysis. Eur Eat Disord Rev 2014; 22:92-101. [PMID: 24277724 DOI: 10.1002/erv.2271] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Revised: 10/21/2013] [Accepted: 10/22/2013] [Indexed: 11/12/2022]
Abstract
Eating disorders in dancers are thought to be common, but the exact rates remain to be clarified. The aim of this study is to systematically compile and analyse the rates of eating disorders in dancers. A literature search, appraisal and meta-analysis were conducted. Thirty-three relevant studies were published between 1966 and 2013 with sufficient data for extraction. Primary data were extracted as raw numbers or confidence intervals. Risk ratios and 95% confidence intervals were calculated for controlled studies. The overall prevalence of eating disorders was 12.0% (16.4% for ballet dancers), 2.0% (4% for ballet dancers) for anorexia, 4.4% (2% for ballet dancers) for bulimia and 9.5% (14.9% for ballet dancers) for eating disorders not otherwise specified (EDNOS). The dancer group had higher mean scores on the EAT-26 and the Eating Disorder Inventory subscales. Dancers, in general, had a higher risk of suffering from eating disorders in general, anorexia nervosa and EDNOS, but no higher risk of suffering from bulimia nervosa. The study concluded that as dancers had a three times higher risk of suffering from eating disorders, particularly anorexia nervosa and EDNOS, specifically designed services for this population should be considered.
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Affiliation(s)
- Jon Arcelus
- Loughborough University Centre for Research into Eating Disorders (LUCRED), Loughborough University, Loughborough, Leicestershire, UK; Eating Disorders Service, Leicester Partnership Trust, Bennion Centre, Leicester Glenfield Hospital, Leicester, UK
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Brunstrom JM, Witcomb GL. Automatic and nonautomatic processes in dietary restraint: further evidence for a commonality between food and drug abstinence. Eat Behav 2004; 5:365-73. [PMID: 15488450 DOI: 10.1016/j.eatbeh.2004.04.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2004] [Revised: 03/15/2004] [Accepted: 04/19/2004] [Indexed: 11/30/2022]
Abstract
The deleterious effect of dietary restraint on cognitive performance is now well established. However, recent evidence suggests that this impairment shares characteristics with those found in abstinent drug users. In this study, high (n=21) and low-to-medium restrained eaters (n=41) completed a reaction-time task, once while imagining their favourite food and once while imagining their favourite holiday. Afterwards, these participants ate lunch and then completed a second set of reaction-time measures. Both before and after lunch, ratings of the vividness of the scenarios were similar across groups. Likewise, the groups produced similar ratings of hunger, thirst, and desire to eat. However, as predicted, performance was significantly impaired in restrained eaters, but only while imagining food, and only before lunch. No impairments were observed in the low-to-medium restrained group. This finding provides further evidence that Tiffany's [Psychol. Rev. 97 (1990) 147] model of drug-related urges can be generalised to dietary restraint. The merits of conceptualising dietary restraint in terms of automatic and nonautomatic processes are discussed, together with suggestions for future research.
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Affiliation(s)
- Jeffrey M Brunstrom
- Department of Human Sciences, Loughborough University, Loughborough, LE11 3TU Leicestershire, UK.
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Brunstrom JM, Yates HM, Witcomb GL. Dietary restraint and heightened reactivity to food. Physiol Behav 2004; 81:85-90. [PMID: 15059687 DOI: 10.1016/j.physbeh.2004.01.001] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2003] [Revised: 01/06/2004] [Accepted: 01/12/2004] [Indexed: 11/17/2022]
Abstract
Previously, studies have explored the relationship between dietary behavior and salivary reactivity to food. Despite this, it remains unclear which behaviors are associated with enhanced reactivity. One problem is that measures of behavior have not been compared directly. In particular, it is unclear whether elevated reactivity is associated with measures of dietary restraint or with measures of failed dietary control and a tendency to overeat. To address this problem, we compared the association between salivary reactivity and scores on the subscales of the Three-Factor Eating Questionnaire (restraint, disinhibition, and hunger). Estimates of reactivity were derived from the difference between a baseline saliva measure and a similar measure taken in close proximity to hot pizza. Our second aim was to explore how salivary reactivity changes after a meal. Female participants (N=40) were tested before and after a lunch (cheese sandwiches). All tended to show reactivity to pizza before but not after lunch. No significant differences were associated with the disinhibition or hunger subscales. However, prelunch reactivity was significantly greater in those participants with high scores on the restraint scale. This does not appear to be related to reported levels of hunger before lunch. Rather, it may reveal an intrinsic difference between the reaction of restrained and unrestrained eaters to food.
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Affiliation(s)
- Jeffrey M Brunstrom
- Department of Human Sciences, Loughborough University, Loughborough, Leicestershire LE11 3TU, UK.
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