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Romano KA, Sandoval CM, Lewis RJ, Heron KE. Daily Relationship Functioning and Disordered Eating Behaviors Among Sexual Minority Women in Same-Sex Relationships. Ann Behav Med 2024:kaae016. [PMID: 38581675 DOI: 10.1093/abm/kaae016] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2024] Open
Abstract
BACKGROUND AND PURPOSE The present study aimed to examine associations between different types of relationship functioning and disordered eating behaviors (DEBs) in the everyday lives of sexual minority women in same-sex relationships-an at-risk population that has not been assessed in this context. METHODS Participants included 321 young sexual minority women (Mage = 27.56, SD = 3.67) in same-sex relationships who completed surveys assessing their daily relationship functioning and DEB use each day for a 14-day daily diary period. Multilevel structural equation modeling was used to examine daily-, person-, and couple-level associations among women's daily relationship functioning (general relationship functioning, positive and negative relational behaviors they and, separately, their partners engaged in) and DEBs (overeating, loss of control eating, emotional eating, and dietary restriction). RESULTS Results generally indicated that more positive and less negative daily relationship functioning across all assessed constructs was associated with less same-day emotional eating. In contrast, associations between all daily relationship functioning constructs and loss of control eating were not significant, nor were any relationship functioning-DEB associations at the couple level. More circumscribed patterns of association were identified for associations between the relationship functioning constructs, and overeating and dietary restriction. CONCLUSIONS Collectively, these findings provide insight into how aspects of daily relationship functioning map onto sexual minority women's daily engagement in DEBs that are linked to poor health long-term, and directions for future research and clinical practice that may warrant consideration moving forward to help advance the evidence-base and care for this historically overlooked and underserved population.
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Affiliation(s)
- Kelly A Romano
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN, USA
| | | | - Robin J Lewis
- Virginia Consortium Program in Clinical Psychology, Norfolk, VA, USA
- Department of Psychology, Old Dominion University, Norfolk, VA, USA
| | - Kristin E Heron
- Virginia Consortium Program in Clinical Psychology, Norfolk, VA, USA
- Department of Psychology, Old Dominion University, Norfolk, VA, USA
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Romano KA, Heron KE, Arigo D. Temporal Sequencing of Naturalistic Associations Between Body Satisfaction and Physical Activity: An Ecological Momentary Assessment Study Among Women in Midlife With Elevated Cardiovascular Risk. J Sport Exerc Psychol 2023; 45:316-324. [PMID: 37922894 DOI: 10.1123/jsep.2022-0281] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 08/14/2023] [Accepted: 10/03/2023] [Indexed: 11/07/2023]
Abstract
The goal of the present study was to examine naturalistic associations between body satisfaction and physical activity (PA) among women in midlife. Women 40-60 years of age with cardiovascular risk factors (e.g., hypertension; N = 75; Mage = 51.63) responded to five surveys per day for 10 days while accelerometer-derived PA measurements were collected continuously. PA parameters included cognitive determinants (PA motivation and intentions) and accelerometer-measured PA behavior (sedentary behavior, light-intensity PA, and moderate to vigorous PA). Multilevel models indicated that associations between body satisfaction and everyday PA differed across PA determinants, time frames (concurrent and prospective), and levels (momentary, daily, and person). For example, positive bidirectional associations were identified between women's daily body satisfaction and PA motivation, whereas greater momentary light-intensity PA (but not moderate to vigorous PA) was unidirectionally associated with greater body satisfaction at a subsequent prompt. These findings provide insight into how associations between body satisfaction and PA unfold in the daily lives of women in midlife and highlight the complexities of these associations.
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Affiliation(s)
- Kelly A Romano
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN, USA
- Virginia Consortium Program in Clinical Psychology, Norfolk, VA, USA
| | - Kristin E Heron
- Virginia Consortium Program in Clinical Psychology, Norfolk, VA, USA
- Old Dominion University, Norfolk, VA, USA
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Romano KA, Heron KE, Sandoval CM, MacIntyre RI, Howard LM, Scott M, Mason TB. Weight Bias Internalization and Psychosocial, Physical, and Behavioral Health: A Meta-Analysis of Cross-Sectional and Prospective Associations. Behav Ther 2023; 54:539-556. [PMID: 37088509 PMCID: PMC10126478 DOI: 10.1016/j.beth.2022.12.003] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 10/25/2022] [Accepted: 12/08/2022] [Indexed: 12/24/2022]
Abstract
Coinciding with widespread efforts to address obesity, weight bias internalization (a process of self-devaluation wherein individuals apply weight-biased stereotypes to themselves) has gained increased attention as a robust correlate of poor health outcomes. The present meta-analysis aimed to provide the largest quantitative synthesis of associations between weight bias internalization and health-related correlates. Studies that provided zero-order correlations for cross-sectional or prospective associations between weight bias internalization and physical, psychosocial, and behavioral health correlates were included in the meta-analysis. Meta-regression determined whether these associations differed based on demographic (sex/gender, race, age), anthropometric (body mass index), and study-level (publication status, sample type, study quality) moderators. Data for 149 (sub)samples were identified that included between 14 and 18,766 participants (M sample size = 534.96, SD = 1,914.43; M age = 34.73, SD = 12.61, range = 9.95-65.70). Results indicated that greater weight bias internalization was concurrently associated with worse psychosocial (e.g., negative and positive mental health, social functioning), physical (e.g., BMI, weight maintenance, health-related quality of life [HRQoL]), and behavioral health (e.g., disordered eating behaviors, healthy eating, physical activity) across most constructs, with effects ranging from small to very large in magnitude. Preliminary evidence also suggested that greater weight bias internalization was subsequently associated with less weight loss and increased negative mental health. Notable variations in the nature and magnitude of these associations were identified based on the health-related correlate and moderator under consideration. These findings indicate that weight bias internalization is linked to multiple adverse health-related outcomes and provide insight into priorities for future research, theory building, and interventions in this area.
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Affiliation(s)
| | - Kristin E Heron
- The Virginia Consortium Program in Clinical Psychology; Old Dominion University
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Romano KA, Heron KE. Daily weight stigma experiences, and disordered and intuitive eating behaviors among young adults with body dissatisfaction. Int J Eat Disord 2023; 56:538-550. [PMID: 36408855 DOI: 10.1002/eat.23859] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 11/09/2022] [Accepted: 11/11/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The present study aimed to extend naturalistic weight stigma research by examining the following aims among young adults with body dissatisfaction and varied body mass indices (BMIs): (1) characterize the frequency of individuals' daily weight stigma experiences, and contextual variations, over a 14-day period; (2) examine whether BMI moderated daily associations between weight stigma experiences relative to eating disorder symptoms and intuitive eating behaviors. METHOD Women (n = 174) and men (n = 24) completed a 14-day daily diary protocol. Concurrent and time-lagged multilevel models examined associations between daily weight stigma, and eating disorder and intuitive eating behaviors among women only due to the small subsample of men. RESULTS Over the 14-day assessment, 43.94% (n = 87) of participants experienced weight stigma. Weight stigma rates varied based on how, where, and by whom weight stigma was expressed, and via BMI. Further, among women, multiple concurrent within-person associations were identified between women's daily weight stigma experiences and daily eating disorder symptoms (skipping meals, binge eating, and body dissatisfaction). Time-lagged associations also showed that women's weight stigma experiences on a given day were associated with a greater likelihood that they would limit the amount of food they consumed the next day. These associations did not differ via women's BMIs. DISCUSSION Collectively, these findings provide important information on how weight stigma experiences unfold in daily life among individuals with body dissatisfaction and varied BMIs, and the proximal and more enduring impact of women's daily weight stigma experiences on their use of multiple adverse eating behaviors that can promote poor health. PUBLIC SIGNIFICANCE The present findings provide important information on how, where, and by whom weight stigma experiences unfold in daily life among young adults with body dissatisfaction and varied body weights, as well as the proximal and more enduring impact of women's daily weight stigma experiences on their use of a variety of adverse eating behaviors that can promote poor health.
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Affiliation(s)
- Kelly A Romano
- Virginia Consortium Program in Clinical Psychology, Norfolk, Virginia, USA
| | - Kristin E Heron
- Virginia Consortium Program in Clinical Psychology, Norfolk, Virginia, USA
- Old Dominion University, Norfolk, Virginia, USA
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Romano KA, Heron KE, Ferguson G, Scott SB. Emotion word use patterns and eating disorder symptoms: Considering the circumplex model of affect and basic emotions theory. Int J Eat Disord 2023; 56:464-469. [PMID: 36571239 PMCID: PMC9898121 DOI: 10.1002/eat.23879] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 12/06/2022] [Accepted: 12/09/2022] [Indexed: 12/27/2022]
Abstract
OBJECTIVE No prior research has examined whether the types of emotion words individuals use to describe their affective experiences cluster along affective dimensions inherent within leading affect theories, or how such emotion word use maps onto eating disorder (ED) symptoms. METHOD To address these gaps, latent profile analysis was used to empirically-identify groups of young adults (N = 352) by how often they use emotion words characterized by the circumplex model of affect's valence-arousal dimensions and basic emotions theory's basic versus complex emotion word categorizations. Auxiliary analyses examined differences in groups' ED symptoms (binge eating, purging, restricting, excessive exercising, muscle building, body dissatisfaction, and cognitive restraint). RESULTS The 5-profile valence-arousal model and 4-profile basic-complex model were the best-fitting theoretically-supported solutions. Valence-arousal profiles with greater negative affect valence generally exhibited worse ED pathology than others, whereas profiles with greater positive affect valence produced inconsistent risk- and protective-factor relations with distinct ED symptoms. Basic-complex profiles characterized by frequent use of both basic and complex emotion words generally had the greatest ED severity, and profiles with greater basic emotion word use exhibited elevated binge eating. DISCUSSION Individual-differences in young adults' emotion word use patterns, versus sample-level averages only, warrant further consideration in ED prevention and research. PUBLIC SIGNIFICANCE The present findings suggest that young adults differ in the types of words they use to describe their emotional experiences, and that these unique emotion word use patterns are linked to distinct eating disorder symptoms. These sources of variation warrant further consideration in eating disorders prevention efforts and future research seeking to advance affect-based eating disorders theories.
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Affiliation(s)
- Kelly A. Romano
- Virginia Consortium Program in Clinical Psychology, 555 Park Avenue, Norfolk, VA 23504, USA
| | - Kristin E. Heron
- Virginia Consortium Program in Clinical Psychology, 555 Park Avenue, Norfolk, VA 23504, USA
- Old Dominion University, 250 Mills Godwin Building, Norfolk, VA 23529, USA
| | - Giselle Ferguson
- Stony Brook University, 100 Nicolls Road, Stony Brook, NY 11794, USA
| | - Stacey B. Scott
- Stony Brook University, 100 Nicolls Road, Stony Brook, NY 11794, USA
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Romano KA, Lipson SK, Beccia AL, Quatromoni PA, Murgueitio J. Disparities in eating disorder symptoms and mental healthcare engagement prior to and following the onset of the COVID-19 pandemic: Findings from a national study of US college students. Int J Eat Disord 2023; 56:203-215. [PMID: 36479981 PMCID: PMC9851957 DOI: 10.1002/eat.23869] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 11/25/2022] [Accepted: 11/26/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Early COVID-19 eating disorders (EDs) research used regionally restricted samples with little sociodemographic diversity. The present study aimed to address these research gaps by examining whether pandemic-related changes in ED symptoms and mental healthcare prevalence differed for historically marginalized groups within a national sample of US college students. METHOD Participants included 242,906 US college students (Mage = 23.45, SD = 7.04; MBMI = 25.28, SD = 5.91) who completed the repeated cross-sectional multi-institute Healthy Minds Study between January 2019 and May 2021. Moderated logistic regressions examined whether pandemic-related changes in individuals' likelihoods of exhibiting current probable ED, reporting lifetime ED diagnoses, and-among individuals with current probable ED-mental healthcare engagement differed for diverse gender, sexual, and racial/ethnic identity groups, and by body mass index (BMI) and financial stress. RESULTS There were increases of 5% and 12% in individuals' likelihoods of exhibiting current probable ED and symptomatic individuals' mental healthcare engagement, respectively, pre- to post-COVID-19 onset, but no pandemic-related changes in lifetime ED diagnosis prevalence. There were also important variations in these time-trends for different marginalized groups. For example, individuals identifying as genderqueer/gender nonconforming and lesbian exhibited increasing ED symptoms pre- to post-COVID-19 onset, and individuals with current probable ED and higher BMIs were increasingly likely to receive mental healthcare. Associations between financial stress, and the ED and mental healthcare outcomes did not change over time. DISCUSSION These findings provide insight into groups of US college students that experienced disproportionate ED burden during the pandemic at the population level, and directions for research and interventions that warrant consideration.
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Affiliation(s)
- Kelly A Romano
- Department of Psychology, Virginia Consortium Program in Clinical Psychology, Norfolk, Virginia, USA
| | - Sarah K Lipson
- Boston University School of Public Health, Department of Health Law Policy and Management, Boston, Massachusetts, USA
| | - Ariel L Beccia
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Paula A Quatromoni
- Department of Health Sciences, College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, Massachusetts, USA
| | - Jose Murgueitio
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Arigo D, Romano KA, Pasko K, Travers L, Ainsworth MC, Jackson DA, Brown MM. A scoping review of behavior change techniques used to promote physical activity among women in midlife. Front Psychol 2022; 13:855749. [PMID: 36211932 PMCID: PMC9534296 DOI: 10.3389/fpsyg.2022.855749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 08/15/2022] [Indexed: 11/13/2022] Open
Abstract
Women in midlife experience health risks that could be mitigated by regular physical activity and reduced sedentary time, but this population rarely achieves physical activity levels that would protect their health. As a result, many behavioral interventions are designed to promote physical activity in this population, which are purportedly guided by theoretical models of health behavior (change) and activate an associated set of behavior change techniques (BCTs). The efficacy and effectiveness of these interventions appear to be limited, however, raising questions about their design and adaptation for women in midlife. Several aspects of these interventions are currently unclear. Specifically, which women they target (i.e., how “midlife” and “sedentary” or “inactive” are defined), which theoretical models or behavior BCTs are used, and how BCTs are activated in such interventions. A synthesis of this information would be useful as an initial step toward improving physical activity interventions for this at-risk group, and thus, represented the goal of the present scoping review. Eligibility required publication in a peer-reviewed journal in English between 2000 and 2021, inclusion of only women in midlife who did not have any medical or other restrictions on their physical activity (e.g., cancer diagnosis), and free-living physical activity or sedentary behavior as the target outcome (with associated assessment). Of the 4,410 initial results, 51 articles met inclusion criteria, and these described 36 unique interventions. More than half of the articles (59%) named an underlying theoretical model and interventions included an average of 3.76 identifiable BCTs (range 1–11). However, descriptions of many interventions were limited and did not provide enough detail to determine whether or how specific BCTs were activated. Interventions also used a wide range of inclusion criteria for age range and starting activity level, which has implications for targeting/tailoring and effectiveness, and many interventions focused on marginalized populations (e.g., women from racial/ethnic minority backgrounds, those un- or under-insured). The present review identifies some strengths and highlights important limitations of existing literature, as well as key opportunities for advancing the design and potential utility of physical activity interventions for women in midlife.
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Affiliation(s)
- Danielle Arigo
- Department of Psychology, Rowan University, Glassboro, NJ, United States
- Department of Family Medicine, Rowan School of Osteopathic Medicine, Stratford, NJ, United States
- *Correspondence: Danielle Arigo
| | - Kelly A. Romano
- Department of Psychology, Old Dominion University, Norfolk, VA, United States
| | - Kristen Pasko
- Department of Psychology, Rowan University, Glassboro, NJ, United States
| | - Laura Travers
- Department of Psychology, Rowan University, Glassboro, NJ, United States
| | - M. Cole Ainsworth
- Department of Psychology, Rowan University, Glassboro, NJ, United States
| | - Daija A. Jackson
- Clinical Psychology Program, Chicago School of Professional Psychology, Washington, DC, United States
| | - Megan M. Brown
- Department of Psychology, Rowan University, Glassboro, NJ, United States
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Sandoval CM, Romano KA, Heron KE, Dawson CA, Sutton TG, Winstead BA, Lewis RJ. Associations between body dissatisfaction and relationship functioning among same-sex female couples: An actor-partner interdependence model. J Fam Psychol 2022; 36:780-790. [PMID: 34968096 PMCID: PMC9651090 DOI: 10.1037/fam0000945] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Nearly all past research about body dissatisfaction and romantic relationship factors is among heterosexual couples; little is known about these associations in sexual minority couples. The present study aimed to fill gaps in the current literature by using actor-partner interdependence models (APIMs) to examine dyadic patterns of association between body dissatisfaction and different aspects of relationship functioning among same-sex female couples. Participants were 163 same-sex female romantic dyads (326 women) between the ages of 18-35 years who completed measures of body dissatisfaction and relationship factors. Results from significance testing of actor and partner effects indicated higher levels of women's own body dissatisfaction were associated with lower levels of their own, but not their partner's, relationship satisfaction, closeness, sexual satisfaction, and intimacy/connectedness. Significance testing alone indicated that the association between one's own body dissatisfaction and their partner's relationship satisfaction was not significant. However, dyadic pattern testing identified a partner pattern for this effect, which suggests that the association between one's own body dissatisfaction and one's own relationship satisfaction is similar in magnitude and direction as that between an individuals' own body dissatisfaction and their partner's relationship satisfaction. In this study, women's own body dissatisfaction was found to be negatively associated with their own relationship functioning, which is consistent with findings of women in male-female couples. Thus, these findings highlight the important role that body dissatisfaction plays in women's relationship experiences. More research is needed to better understand potential cross-partner effects of body dissatisfaction and relationship factors in same-sex female couples. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
| | | | - Kristin E. Heron
- Virginia Consortium Program in Clinical Psychology
- Old Dominion University
| | | | | | | | - Robin J. Lewis
- Virginia Consortium Program in Clinical Psychology
- Old Dominion University
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Romano KA, Lipson SK, Beccia AL, Quatromoni PA, Gordon AR, Murgueitio J. Changes in the prevalence and sociodemographic correlates of eating disorder symptoms from 2013 to 2020 among a large national sample of U.S. young adults: A repeated cross-sectional study. Int J Eat Disord 2022; 55:776-789. [PMID: 35338504 PMCID: PMC9204707 DOI: 10.1002/eat.23709] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [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: 10/20/2021] [Revised: 03/13/2022] [Accepted: 03/14/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The present study aimed to: (1) identify recent temporal changes in the prevalence of different cognitive and behavioral eating disorder (ED) symptoms, current probable EDs, lifetime ED diagnoses, and mental healthcare use among college students across the United States; (2) determine whether established disparities in ED prevalence and receiving mental healthcare have widened or narrowed over time for marginalized groups within this population. METHOD Participants included a large national sample of U.S. college students (N = 286,720) who completed the repeated cross-sectional Healthy Minds Study from 2013 to 2020. Descriptive statistics and polynomial regressions quantified time-trends in participants' ED symptoms and past 12-month mental healthcare. Moderated regressions examined temporal changes in ED symptoms and mental healthcare based on sociodemographic characteristics. RESULTS Individuals' engagement in different cognitive and behavioral ED symptoms, and likelihoods of exhibiting current probable EDs, reporting lifetime ED diagnoses, and (for individuals with current probable EDs) receiving therapy or counseling in the past 12-months exhibited nonlinear increases from 2013 to 2020. Further, the prevalence of current and lifetime ED symptoms and (for symptomatic individuals) past 12-month mental healthcare differed over time for individuals with different BMIs and gender, sexual, and racial/ethnic identities (but not ages). In particular, individuals with higher BMIs and those who identified as male, bisexual, and gay, lesbian, or queer exhibited increasing ED pathology over time. DISCUSSION These findings provide important information on groups of U.S. college students that have experienced increasing burden of ED symptoms and may help guide ED prevention, treatment, and research priorities. PUBLIC SIGNIFICANCE Recent temporal changes in the prevalence of eating disorder (ED) symptoms and mental healthcare were examined in a national sample of U.S. young adults. Non-linear increases in ED symptoms and mental healthcare were identified among U.S. young adults overall from 2013 to 2020. U.S. young adults with higher BMIs, males, bisexual, and gay, lesbian, or queer individuals exhibited increasing ED burden over time.
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Affiliation(s)
- Kelly A. Romano
- The Virginia Consortium Program in Clinical Psychology, Norfolk, Virginia, USA
| | - Sarah K. Lipson
- Department of Health Law Policy and Management, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Ariel L. Beccia
- Clinical and Population Health Research Program, Morningside Graduate School of Biomedical Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA,Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Paula A. Quatromoni
- Department of Health Sciences, Boston University, Boston, Massachusetts, USA
| | - Allegra R. Gordon
- Department of Community Health Science, Boston University School of Public Health, Boston, Massachusetts, USA,Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, Massachusetts, USA
| | - Jose Murgueitio
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Romano KA, Heron KE, Everhart RS. Family meals, positive versus negative emotion suppression, and emotional eating: examining adolescent-parent dyadic associations. Eat Weight Disord 2022; 27:1491-1504. [PMID: 34468974 DOI: 10.1007/s40519-021-01292-4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 08/23/2021] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The present study aimed to extend existing research by examining adolescent-parent dyadic associations among adaptive and maladaptive family meal characteristics, positive and negative emotion suppression, and emotional eating. METHOD Participants included a community-based sample of adolescents and parents (N = 1646 dyads) who participated in the National Cancer Institute's Family Life, Activity, Sun, Health, and Eating Study. Dyad members both completed measures assessing family meal characteristics (family meal importance beliefs, family mealtime television watching), emotion suppression, and emotional eating via online surveys. Actor-partner interdependence models were used to examine dyadic associations among the assessed family meal characteristics, positive and negative emotion suppression, and emotional eating. RESULTS Multiple within-person (e.g., adolescent-adolescent, parent-parent), cross-dyad member (e.g., adolescent-parent, parent-adolescent), and divergent adolescent versus parent dyadic effects were identified that differed based on the extent to which participants suppressed positive versus negative affect. For example, whereas adolescents' stronger beliefs in the importance of frequent family meals were associated with lower levels of their own suppression of positive emotions and, in turn, lower levels of both their own and their parents' emotional eating, these mediational associations were only identified at the within-person (not cross-dyad member) level among parents. CONCLUSIONS Collectively, these findings attest to the complexity of associations among the assessed risk and protective family meal characteristics, the suppression of differentially valenced emotions, and emotional eating that manifest at the adolescent-parent dyadic level. Findings also support the continued use of a family-based perspective to further the understanding of factors that are associated with emotional eating. LEVEL OF EVIDENCE Level V, cross-sectional descriptive study.
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Affiliation(s)
- Kelly A Romano
- The Virginia Consortium Program in Clinical Psychology, 555 Park Avenue, Norfolk, VA, 23504, USA. .,Old Dominion University, 250 Mills Godwin Building, Norfolk, VA, 23529, USA.
| | - Kristin E Heron
- The Virginia Consortium Program in Clinical Psychology, 555 Park Avenue, Norfolk, VA, 23504, USA.,Old Dominion University, 250 Mills Godwin Building, Norfolk, VA, 23529, USA
| | - Robin S Everhart
- Virginia Commonwealth University, 808 West Franklin Street, Richmond, VA, 23284, USA
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Romano KA, Heron KE, Sandoval CM, Howard LM, MacIntyre RI, Mason TB. A meta-analysis of associations between weight bias internalization and conceptually-related correlates: A step towards improving construct validity. Clin Psychol Rev 2022; 92:102127. [PMID: 35074712 PMCID: PMC8858873 DOI: 10.1016/j.cpr.2022.102127] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 06/11/2021] [Revised: 11/15/2021] [Accepted: 01/09/2022] [Indexed: 12/13/2022]
Abstract
Weight bias internalization (WBI), a process of weight-based self-devaluation, has been associated with adverse mental and physical health. However, there are limitations with the existing conceptualization and operationalization of WBI that raise questions about the implications of this evidence-base. To address these limitations, the present study investigated the construct validity of WBI by conducting a meta-analysis of associations between WBI (as currently operationalized) and conceptually-related correlates. Studies identified through October 2021 that provided zero-order correlations for associations between WBI and conceptually-related constructs were examined. Meta-regression determined whether these associations differed across WBI measures and demographic (age, sex/gender, race, BMI) and study-level (publication status, sample type, study quality) moderators. Data for 128 (sub)samples were identified (Msample size = 477.83, SD = 1679.90; Mage = 34.46, SD = 12.17; range = 10.21-56.60). Greater WBI exhibited large to very large associations with factors suggested to have considerable overlap with this construct (negative and positive body image, self-devaluation), general and weight-specific experiential avoidance, and individuals' anticipation of future weight stigma. Associations varied for other constructs that have been differentially included in conceptualizations of WBI (endorsing weight bias, weight stigma stereotype awareness, weight stigma experiences), and via measurement-related, demographic, and study-level factors. These findings provide important information that can advance WBI conceptualization and measure-refinement.
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Affiliation(s)
- Kelly A. Romano
- The Virginia Consortium Program in Clinical Psychology, Norfolk, VA, USA
| | - Kristin E. Heron
- The Virginia Consortium Program in Clinical Psychology, Norfolk, VA, USA,Department of Psychology, Old Dominion University, Norfolk, VA, USA
| | | | - Lindsay M. Howard
- Department of Psychology, Augustana University, Sioux Falls, SD, USA
| | | | - Tyler B. Mason
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
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Braitman AL, Romano KA, Heron KE, Ehlke SJ, Shappie AT, Lewis RJ. Psychometric analysis and validity of the Daily Sexual Minority Stressors Scale among young adult same-sex female couples. Psychol Assess 2021; 33:1025-1037. [PMID: 34672641 PMCID: PMC10081731 DOI: 10.1037/pas0001073] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Sexual minority women experience greater health disparities relative to heterosexual women, which is thought to be due to unique stressors related to their sexual identities. Daily diary or momentary assessments may provide a more nuanced approach to understanding how sexual minority stressors relate to health behaviors than cross-sectional studies provide. To date, there is no validated measure to examine daily sexual minority stressors. A recent pilot study developed a brief (8-item) measure for assessing sexual minority stressors in self-identified lesbian or mostly lesbian women (Heron et al., 2018). Although an optimal number of items were generated to best capture the daily experiences of lesbian women, psychometric examination and validation of this new measure is necessary. Using multilevel confirmatory factor analysis among a fully scaled sample of sexual minority women, the present study established that the Daily Sexual Minority Stressors Scale has good model fit as a unidimensional measure (i.e., one factor at each level of analysis). Intraclass correlations indicate the majority of variation (57%) is within person. Additionally, we established convergent and discriminant validity using similar measures (single-item assessment, general stressors, negative affect, history of discrimination, and heterosexism). Finally, criterion validity was supported. At the daily level, experiencing daily sexual minority stressors was associated with a significantly greater likelihood of drinking alcohol that day. Experiencing more daily sexual minority stressors during the study period was significantly associated with a history of harassment and discrimination, victimization, isolation, vigilance, and also with acceptance concerns, difficult processes, and internalized homonegativity. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Abby L. Braitman
- Department of Psychology, Old Dominion University
- Virginia Consortium Program in Clinical Psychology
| | | | - Kristin E. Heron
- Department of Psychology, Old Dominion University
- Virginia Consortium Program in Clinical Psychology
| | - Sarah J. Ehlke
- Department of Psychology, Old Dominion University
- TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center
| | | | - Robin J. Lewis
- Department of Psychology, Old Dominion University
- Virginia Consortium Program in Clinical Psychology
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13
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Abstract
Sexual minority women (i.e., women who identify as lesbian, bisexual, or other non-heterosexual orientations) report more hazardous drinking compared to heterosexual women. Sexual minority stress (SMS), or experiences related to sexual orientation-based discrimination and marginalization, have been implicated as contributing to these disparities. The association between sexual minority stress and alcohol use has been supported in cross-sectional, and to a limited extent, longitudinal studies. Few studies, however, have examined associations between SMS and alcohol use in sexual minority women's daily lives. Young sexual minority women (age 18-35; N = 321) were recruited to participate in a 14-day daily diary study in which they reported each morning on their SMS and alcohol use (drinking or not; drinking quantity; alcohol consequences) from the previous day. SMS was operationalized in four ways (global negative SMS experiences, specific SMS events, concealment of identity, discrimination). Results from concurrent multilevel models revealed that on days when sexual minority women experienced more global negative SMS, any specific SMS event, or discrimination, they were more likely to drink. Further, prospective models indicated that participants drank more and were more likely to report binge drinking on the day after they experienced at least one SMS event. These findings extend prior research by demonstrating that the association between SMS and alcohol use extends to the daily level of analysis among sexual minority women. Understanding the connection between SMS and alcohol use among sexual minority women is imperative to developing culturally tailored interventions to improve the health and well-being of this at-risk group. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
| | | | - Sarah J Ehlke
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center
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14
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Romano KA, Lipson SK. Weight misperception and thin-ideal overvaluation relative to the positive functioning and eating disorder pathology of transgender and nonbinary young adults. Psychology of Sexual Orientation and Gender Diversity 2021. [DOI: 10.1037/sgd0000524] [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: 11/08/2022]
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15
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Romano KA, Heron KE, Ebener D. Associations among weight suppression, self-acceptance, negative body image, and eating disorder behaviors among women with eating disorder symptoms. Women Health 2021; 61:791-799. [PMID: 34433381 DOI: 10.1080/03630242.2021.1970082] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 10/20/2022]
Abstract
The present study aimed to clarify existing research that has inconsistently shown that weight suppression (differences between individuals' highest and current body weights) is associated with worse eating disorder (ED) behaviors and negative body image among women with lifetime EDs, by examining whether an understudied client-supported protective factor for ED pathology - self-acceptance - moderates these associations. Currently symptomatic women with lifetime EDs (N = 108) completed measures assessing self-acceptance and ED symptoms via an online survey. Moderated regressions examined whether self-acceptance moderated associations between weight suppression and both body image (weight/shape preoccupation, overvaluation, dissatisfaction) and ED behavior (dietary restraint, compensatory behaviors, binge eating) outcomes. Results indicated that weight suppression was associated with more severe negative body image and dietary restraint, but not compensatory behaviors or binge eating. In contrast, self-acceptance consistently emerged as a protective factor relative to all negative body image and ED behavior indices. This protective effect did not offset apparent risk factor associations between weight suppression, and negative body image and ED behavior outcomes. These results support further assessment of self-acceptance as an understudied protective factor for women's ED symptoms and as a mechanism of change in EDs intervention research. Women's weight suppression should be assessed during ED prevention initiatives.
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Affiliation(s)
- Kelly A Romano
- The Virginia Consortium Program in Clinical Psychology, Norfolk, Virginia, USA
| | - Kristin E Heron
- The Virginia Consortium Program in Clinical Psychology, Norfolk, Virginia, USA.,Department of Psychology, Old Dominion University, Norfolk, Virginia, USA
| | - Deborah Ebener
- Department of Educational Psychology and Learning Systems, Florida State University, Tallahassee, Florida, USA
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Romano KA, Heron KE. Examining Race and Gender Differences in Associations Among Body Appreciation, Eudaimonic Psychological Well-Being, and Intuitive Eating and Exercising. Am J Health Promot 2021; 36:117-128. [PMID: 34350774 DOI: 10.1177/08901171211036910] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 11/16/2022]
Abstract
PURPOSE The present study examined race and gender differences among positive psychological constructs, and adaptive eating and exercise behaviors. DESIGN Cross-sectional. SETTING Online. SAMPLE College students (N = 1,228; Mage = 22.27, SD = 5.83). MEASURES Participants completed measures assessing positive body image, eudaimonic psychological well-being, and health behaviors. ANALYSES Multi-group structural equation modeling was used to examine whether White versus Black race and, separately, woman versus man gender identity moderated associations among body appreciation, eudaimonic psychological well-being, and intuitive eating and intuitive exercising. RESULTS Results generally indicated that greater body appreciation was associated with greater eudaimonic psychological well-being (βs = 0.48, 0.56) and, in turn, intuitive eating (βs = -0.20, 0.25) and intuitive exercising (βs = -0.06, 0.23). However, notable variations in this pattern of results were identified based on the facet of intuitive eating and exercising under investigation, and participants' racial identities. For example, greater eudaimonic psychological well-being strictly mediated a positive association between body appreciation and reliance on hunger and satiety cues intuitive eating behaviors among participants who identified as Black (95%CI: 0.01, 0.12), but not White (95%CI: -0.08, 0.04). CONCLUSIONS Although the present findings warrant replication using longitudinal designs due to the cross-sectional nature of the present study, these findings suggest that increasing adults' eudaimonic psychological well-being may help improve health-promoting eating and exercise behaviors, and should be assessed as a mechanism of change in future clinical research.
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Affiliation(s)
- Kelly A Romano
- 169177The Virginia Consortium Program in Clinical Psychology, Norfolk, VA, USA
| | - Kristin E Heron
- 169177The Virginia Consortium Program in Clinical Psychology, Norfolk, VA, USA.,6042Old Dominion University, Norfolk, VA, USA
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Abstract
The present study aimed to determine how young adults' use of disordered eating behaviors (DEBs) and alcohol uniquely cluster with one another, how these clusters differ by sex and race, and map onto health-related correlates. As a part of a cross-sectional study assessing college student health and experiences, female (n = 1,026), male (n = 336), White (n = 640), and Black (n = 561) young adult college students at three universities (Mage = 20.54, SD = 1.80) completed measures assessing DEBs and alcohol use, and physical and mental health. Multigroup mixture modeling was used to identify subgroups of female, male, White, and Black young adults that are characterized by different levels of DEBs (fasting, food avoidance, loss of control eating, overeating) and alcohol use (binge drinking, drinking quantity). Whether group membership relates to theoretically and clinically relevant health correlates (stress, depressive symptoms, sleep health) was examined via auxiliary analyses. Qualitative and quantitative differences were identified in the best-fitting mixture models for female (four groups), male (four groups), White (five groups), and Black (three groups) participants that suggest sex and racial variations exist in patterns of DEBs and alcohol use severity. Generally, classification in groups characterized by moderate to high probabilities of DEBs only, or the combination of moderate to high DEBs and alcohol use, was associated with worse affective concerns across sexes and races. Targeting young adults' DEBs and alcohol use via diversity-informed treatments focused on coping skill development may help promote health and well-being.
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Affiliation(s)
- Kelly A Romano
- Psychology, The Virginia Consortium Program in Clinical Psychology
| | - Amy Stamates
- Psychology, Old Dominion University, Norfolk, VA, USA
| | - Kristin E Heron
- Psychology, The Virginia Consortium Program in Clinical Psychology.,Psychology, Old Dominion University, Norfolk, VA, USA
| | - Abby L Braitman
- Psychology, The Virginia Consortium Program in Clinical Psychology.,Psychology, Old Dominion University, Norfolk, VA, USA
| | - Cathy Lau-Barraco
- Psychology, The Virginia Consortium Program in Clinical Psychology.,Psychology, Old Dominion University, Norfolk, VA, USA
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18
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Abstract
OBJECTIVE Determine whether gender differences exist in associations among central barriers to and facilitators of eating disorder (ED) help-seeking-ED stigma, negative affect, perceived ED treatment need-as a function of individuals' probability of classification within empirically derived groups characterized by different dietary restraint patterns. METHOD As part of the cross-sectional, multi-institute Healthy Bodies Study, women (n = 2215) and men (n = 986) attending three colleges and universities in 2015 completed measures of ED symptoms, affect, and ED help-seeking in an online survey. Structural equation mixture modeling was used to (1) classify women and men, separately, into distinct classes characterized by unique dietary restraint patterns and (2) test associations among the three ED help-seeking barriers and facilitators within each class. RESULTS Five dietary restraint symptoms (food amount limiting attempts, fasting, food avoidance, following food/diet rules, desiring an empty stomach) clustered within four classes among women and three classes among men, which were characterized by qualitative and quantitative similarities and differences. Further, opposite patterns were generally found in associations among the ED help-seeking barriers and facilitators for women versus men as a function of the way dietary restraint symptoms clustered within each class. For example, bivariate associations between worse ED stigma and negative affect relative to greater perceived ED treatment need were both significant only among women in their lowest restraint severity class, whereas these associations were both significant among men in their highest severity class. DISCUSSION These findings can help to increase the reach of ED intervention efforts, including increasing ED help-seeking rates. LEVEL OF EVIDENCE Level V, cross-sectional descriptive study.
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Affiliation(s)
- Kelly A Romano
- The Virginia Consortium Program in Clinical Psychology, 555 Park Avenue, Norfolk, VA, 23504, USA.
- Old Dominion University, 250 Mills Godwin Building, Norfolk, VA, 23529, USA.
| | - Sarah K Lipson
- Department of Health Law Policy and Management, Boston University School of Public Health, 715 Albany Street, Boston, MA, 02118, USA
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19
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Romano KA, Heron KE, Amerson R, Howard LM, MacIntyre RI, Mason TB. Changes in disordered eating behaviors over 10 or more years: A meta-analysis. Int J Eat Disord 2020; 53:1034-1055. [PMID: 32415907 DOI: 10.1002/eat.23288] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 12/07/2019] [Revised: 04/07/2020] [Accepted: 04/08/2020] [Indexed: 12/25/2022]
Abstract
OBJECTIVE The present meta-analysis evaluated changes in individuals' risk of engaging in distinct disordered eating behaviors (DEBs) in the long-term. METHOD Longitudinal studies assessing changes in DEBs via ≥2 assessments with a time lag of ≥10 years were included. Risk ratios were calculated for baseline to 10-14.9-year (M = 11.04) follow-up and baseline to ≥15-year (M = 18.62) follow-up changes in the use of binge eating, multiple purging, self-induced vomiting, laxatives, diuretics, diet pills, compensatory exercising, fasting/dieting, and multiple DEBs; Cohen's d was used for continuous binge-eating plus purging variable changes. Subgroup and meta-regression analyses tested whether eating disorder (ED) clinical sample versus nonclinical sample status, female versus male sex/gender, higher versus lower study bias, and baseline mean age and body mass index influenced overall effect magnitude for analyses with sufficient data. RESULTS Seventeen studies (26 [sub]samples) were included. Overall, individuals' risk of engaging in various restrictive eating and other compensatory behaviors decreased over time and the magnitudes of risk reductions for the use of certain compensatory DEBs were larger over longer follow-up durations. Specifically, for significant DEB change models, risk reductions spanned from 20.0-39.8% for 10-year follow-up and 24.7-74.8% for ≥15-year follow-up. However, nuances were found in the nature of these DEB changes as a function of DEB type, follow-up length, ED versus nonclinical sample composition, and baseline mean age. CONCLUSIONS These findings provide important information that can help identify treatment priorities and suggest that targeted and tailored preventative ED treatments warrant consistent implementation at the community-level, particularly for youth.
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Affiliation(s)
- Kelly A Romano
- Department of Psychology, the Virginia Consortium Program in Clinical Psychology, Norfolk, Virginia, USA.,Department of Psychology, Old Dominion University, Norfolk, Virginia, USA
| | - Kristin E Heron
- Department of Psychology, the Virginia Consortium Program in Clinical Psychology, Norfolk, Virginia, USA.,Department of Psychology, Old Dominion University, Norfolk, Virginia, USA
| | - Rachel Amerson
- Department of Psychology, the Virginia Consortium Program in Clinical Psychology, Norfolk, Virginia, USA
| | - Lindsay M Howard
- Department of Psychology, the Virginia Consortium Program in Clinical Psychology, Norfolk, Virginia, USA
| | - Rachel I MacIntyre
- Department of Psychology, the Virginia Consortium Program in Clinical Psychology, Norfolk, Virginia, USA
| | - Tyler B Mason
- Department of Preventive Medicine, University of Southern California, Los Angeles, California, USA
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20
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Romano KA, Heron KE. Racial differences in overeating, loss of control eating, and binge eating: Extending core tenets of the Cognitive Behavioral Theory of Eating Disorders. Appetite 2020; 153:104747. [PMID: 32454077 DOI: 10.1016/j.appet.2020.104747] [Citation(s) in RCA: 2] [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: 12/07/2019] [Revised: 05/15/2020] [Accepted: 05/17/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE The present study examined racial differences in associations among body dissatisfaction, body checking, and dietary restraint relative to overeating, loss of control eating, and binge eating outcomes among college women. METHOD Young adult women (N = 903) at three Mid-Atlantic US institutions completed measures assessing negative body image and eating pathology via an online survey. Structural equation modeling was used to test a model examining associations among body dissatisfaction, body checking, dietary restraint, and disinhibited eating behaviors. Multigroup analyses examined whether these associations differed for women who identified as White (n = 432) versus Black (n = 359). RESULTS More frequent body checking explained associations between elevated body dissatisfaction and more frequent use of all three disinhibited eating outcomes for White and Black women, whereas restraint solely mediated an association between body dissatisfaction and overeating. The assessed constructs generally operated in a similar manner across racial groups. However, stronger associations among body dissatisfaction, restraint, and overeating, and between body checking and loss of control eating were identified for women who identified as White versus Black. CONCLUSIONS Eating disorder programming efforts targeting body checking behavior may prove useful in decreasing White and Black women's disinhibited eating.
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Affiliation(s)
- Kelly A Romano
- The Virginia Consortium Program in Clinical Psychology, 555 Park Avenue, Norfolk, VA, 23504, USA.
| | - Kristin E Heron
- The Virginia Consortium Program in Clinical Psychology, 555 Park Avenue, Norfolk, VA, 23504, USA; Old Dominion University, 250 Mills Godwin Building, Norfolk, VA, 23529, USA
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21
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Romano KA, Colgary CD, Swanbrow Becker M, Magnuson A. Prevention of shape and weight concerns among college students: An examination of education status variables. J Am Coll Health 2019; 67:449-458. [PMID: 29979932 DOI: 10.1080/07448481.2018.1486319] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 05/07/2018] [Accepted: 06/04/2018] [Indexed: 06/08/2023]
Abstract
Objective: The current study examined whether overlooked aspects of the postsecondary student experience predicted individuals' body-related concerns, beyond the influence of demographic factors that have upheld explanatory power in past research. Participants: Undergraduate and graduate students (n = 3,259) took part in the multi-institute Healthy Bodies Study during the 2015 academic year. Method: Participants completed an online survey that assessed their undergraduate/graduate statuses, academic majors, extracurricular involvements, and body-related concerns. Hierarchical multiple regression analyses were run to answer primary study questions. Results: Gender, body mass index (BMI), undergraduate/graduate student status, being a male graduate student, major, and extracurricular activities predicted shape concern (SC), weight concern (WC), and whether these concerns increased since students began at their universities. The addition of the student-specific variables uniquely contributed to the variance in body-related concerns. Conclusions: Further research on the body-related discontent of the identified student groups should be conducted to elucidate potential campus-based treatment targets.
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Affiliation(s)
- Kelly A Romano
- a Department of Psychology , Virginia Consortium Program in Clinical Psychology , Norfolk , Virginia , USA
- b Department of Psychology , Old Dominion University , Norfolk , Virginia , USA
| | - Christina D Colgary
- c Educational Psychology and Learning Systems , Florida State University , Tallahassee , Florida , USA
| | - Martin Swanbrow Becker
- c Educational Psychology and Learning Systems , Florida State University , Tallahassee , Florida , USA
| | - Amy Magnuson
- d Health Promotion, Florida State University , Tallahassee , Florida , USA
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Heron KE, Romano KA, Braitman AL. Mobile technology use and mHealth text message preferences: an examination of gender, racial, and ethnic differences among emerging adult college students. Mhealth 2019; 5:2. [PMID: 30842950 PMCID: PMC6378243 DOI: 10.21037/mhealth.2019.01.01] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [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: 09/25/2018] [Accepted: 01/15/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Mobile health (mHealth) interventions are a potentially feasible way of targeting emerging adult college students' physical and mental health concerns, decreasing health-risk, and augmenting health promoting behaviors. However, there is limited evidence attesting to advantageous ways of designing mHealth treatments in a manner that is apt to be well-received by emerging adult college students at large, and gender, racial, and ethnic subgroups in particular. To address these research gaps, this exploratory study examined general trends, and gender (male, female), racial (White, Black), and ethnic (Latino, non-Latino) differences, in emerging adult college students' mobile technology ownership and phone plan characteristics, technology use behaviors, and mHealth text message preferences. METHODS Participants included 1,371 college students aged 18 to 25 (20.54±1.80) years. Between July 2015 and April 2016, students from three universities in the Mid-Atlantic United States completed an online survey assessing technology use. Descriptive statistics and chi-square tests were run to answer primary study questions. RESULTS Results suggest that students frequently engage with mobile devices and inherent features. Overall, nearly all (99.5%) students owned smartphones, 89.5% had long-term phone contracts, 94.6% had unlimited texting, and 38.6% reported having unlimited data plans. Further, 96.8% reported texting, 92.0% accessing email, 97.3% accessing the internet, and 97.2% using apps on their mobile devices at least once per day. When asked about the types of text messages they would prefer to receive in the context of mHealth interventions, most students preferred messages that did not contain textese, were longer vs. shorter, contained a single vs. multiple exclamation marks, had a smiley face emoticon, used capitalization for emphatic purposes, contained a statement vs. a question, were polite in tone, and were non-directive. There was also multiple gender, racial, and ethnic group differences in mobile device ownership and plan attributes, usage patterns, and text message preferences. CONCLUSIONS The present research provides evidence that smartphones are commonly used by college students and may be a feasible platform for health intervention delivery among diverse student groups. mHealth interventions could use the present results to inform the design of future mHealth interventions and, in turn, increase the acceptability, usability, and efficacy of such treatments for college students at large and diverse student groups in particular.
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Affiliation(s)
- Kristin E. Heron
- Department of Psychology, Old Dominion University, Norfolk, VA 23529, USA
- Virginia Consortium Program in Clinical Psychology, Norfolk, VA 23504, USA
| | - Kelly A. Romano
- Virginia Consortium Program in Clinical Psychology, Norfolk, VA 23504, USA
| | - Abby L. Braitman
- Department of Psychology, Old Dominion University, Norfolk, VA 23529, USA
- Virginia Consortium Program in Clinical Psychology, Norfolk, VA 23504, USA
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Romano KA, Ebener D. Disparities in psychological well-being based on subjective and objective eating disorder recovery statuses, and recovery status concordance. Eat Disord 2019; 27:82-99. [PMID: 29791281 DOI: 10.1080/10640266.2018.1477674] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
This research examines how eudaimonic psychological well-being (PWB) relates to variant levels of eating disorder (ED) recovery (full, partial, active ED), both self-defined and objectively determined, and to subjective-objective recovery status concordance. Participants (N = 132; Mage = 30.1) completed an online survey targeting ED symptomology, PWB, and recovery. MANOVAs revealed idiosyncratic relationships between recovery and PWB when objective criteria, subjective perceptions, and concordance were considered. Generally, superior levels of recovery were associated with superior PWB. PWB and clients' perceptions of recovery should be considered during treatment and in establishing a uniform definition of ED recovery.
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Affiliation(s)
- Kelly A Romano
- a Department of Educational Psychology and Learning Systems , Florida State University , Tallahassee , FL USA
| | - Deborah Ebener
- a Department of Educational Psychology and Learning Systems , Florida State University , Tallahassee , FL USA
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Romano KA, Swanbrow Becker MA, Colgary CD, Magnuson A. Helpful or harmful? The comparative value of self-weighing and calorie counting versus intuitive eating on the eating disorder symptomology of college students. Eat Weight Disord 2018; 23:841-848. [PMID: 30155857 DOI: 10.1007/s40519-018-0562-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [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: 05/06/2018] [Accepted: 08/11/2018] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE The current study evaluated the comparative implications of self-weighing and calorie counting versus intuitive eating (IE) on the eating disorder (ED) severity of college students. METHODS In this cross-sectional study, college students in the US [N = 902; 68% female; mean body mass index (BMI) = 24.3] completed the web-based Healthy Bodies Study in 2015. RESULTS A hierarchical multiple regression analysis revealed that elevated BMI, more frequent self-weighing and calorie counting, and lower IE scores predicted increased ED severity. The results of Kruskal-Wallis H tests indicated that participants with elevated weight statuses engaged in self-weighing and calorie counting more frequently, and possessed lower IE scores, than their lower weight counterparts. CONCLUSION Engaging in self-weighing and calorie counting was adversely associated with ED severity among the present sample of college students. Cultivating IE within health promotion efforts may, instead, lead to favorable eating-related outcomes that may translate to the holistic health of this population. LEVEL OF EVIDENCE V cross-sectional descriptive study.
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Affiliation(s)
- Kelly A Romano
- Department of Educational Psychology and Learning Systems, Florida State University, 1114 West Call Street, Tallahassee, FL, 32306, USA. .,The Virginia Consortium Program in Clinical Psychology, Department of Psychology, Old Dominion University, 250 Mills Godwin Building, Norfolk, VA, 23529, USA.
| | - Martin A Swanbrow Becker
- Department of Educational Psychology and Learning Systems, Florida State University, 1114 West Call Street, Tallahassee, FL, 32306, USA
| | - Christina D Colgary
- Department of Educational Psychology and Learning Systems, Florida State University, 1114 West Call Street, Tallahassee, FL, 32306, USA
| | - Amy Magnuson
- University Health Services, Florida State University, 960 Learning Way, Tallahassee, FL, 32306, USA
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25
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Romano KA. Ethical considerations for clinical work with fat clients: Psychologists’ roles. Professional Psychology: Research and Practice 2018. [DOI: 10.1037/pro0000193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Romano KA, Colgary CD, Magnuson A. Global Health Promotion on College Campuses: Considerations for Use of eHealth and mHealth Self-monitoring Applications with Nutritional Food Labeling Features. American Journal of Health Education 2017. [DOI: 10.1080/19325037.2017.1335629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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