Search

Objective: To investigate the knowledge, attitudes, and current practices of adolescent primary care providers regarding the epidemiology, clinical features, and diagnosis of atypical anorexia nervosa (AN) compared to AN. Methods: An online survey was sent to the Pediatric and Family Medicine clinicians who provide medical care to adolescents. Statistical analyses compared differences in responses to questions about atypical AN versus AN. Results: Relative to AN, participants (n = 67) were significantly less familiar with atypical AN, less likely to consider a diagnosis of atypical AN, less comfortable identifying atypical AN, less likely to counsel patients with atypical AN on health risks, less likely to refer patients with atypical AN to a specialist, and less likely to correctly identify atypical AN. Clinicians with more years in medical practice reported a significantly larger gap in familiarity between AN and atypical AN than clinicians with less than 5 years of practice. Conclusions: Providers who care for adolescents appear to be less familiar with and less likely to identify atypical AN compared to AN. This knowledge gap may be more pronounced among clinicians with more years practicing medicine due to the novelty of atypical AN as a diagnosis. Lack of knowledge surrounding atypical AN risk factors may result in delayed diagnosis and associated poor health outcomes. Future research should investigate strategies that improve knowledge and screening of atypical AN in medical and other settings. Public Significance: Pediatric and Family Medicine clinicians are less familiar with atypical anorexia nervosa (AN) and less likely to diagnose a patient with atypical AN relative to AN. Insufficient knowledge about atypical AN may place these individuals at increased risk for worsening restrictive eating and the physical and psychological consequences of malnutrition. [ABSTRACT FROM AUTHOR]

Objective: Little is known about how individuals with atypical anorexia nervosa (AN) respond to eating disorder (ED) treatment in a partial hospitalization program (PHP), nor how certain factors such as trauma, childhood abuse, psychiatric comorbidity, and suicidal thoughts and behaviors might contribute to poor treatment outcomes. Thus, the current study (1) compares prevalence of these factors between individuals with AN and atypical AN upon admission to an ED PHP, (2) compares PHP treatment response between groups, and (3) investigates whether experiencing these factors impacts treatment outcomes. Method: We conducted a retrospective chart review of young adults admitted to a PHP with AN (n = 95) and atypical AN (n = 59). Histories of psychiatric comorbidities and adverse childhood experiences were obtained from initial psychiatric evaluations. ED symptoms were assessed at intake and discharge with the Eating Disorder Examination‐Questionnaire (EDE‐Q). Results: No significant differences were found at intake in ED symptom severity or prevalence of lifetime trauma, childhood abuse, number of psychiatric diagnoses, or suicidal thoughts and behavior. Symptomatology at discharge also did not differ between groups. Emotional abuse was significantly related to discharge shape and weight overvaluation. No other intake characteristics were significantly related to discharge symptomatology. Discussion: To our knowledge, this is the first study to compare the prevalence of comorbidities for both AN and atypical AN, as well as differential treatment outcomes for these individuals in a PHP. Results add to growing literature suggesting that, other than weight, AN and atypical AN have few properties that reliably distinguish them from one another. Public Significance: This study adds to a growing body of literature that raises questions about whether anorexia nervosa (AN) and atypical AN are truly different diagnoses. Our findings suggest these two groups present to treatment in a partial hospitalization program (PHP) with similar ED symptoms, as well as prevalence of lifetime trauma, childhood abuse, suicidal thoughts and behavior, and number of psychiatric comorbidities, and demonstrate similar treatment trajectories in PHP. [ABSTRACT FROM AUTHOR]

This study examined the feasibility and preliminary effectiveness of a cognitive‐behavioral, family‐centered partial hospitalization program (PHP) for adolescents with anorexia nervosa (AN) and atypical AN (AAN), and described the outpatient services received following discharge. Participants (N = 31) completed anthropometric and self‐report assessments at admission, discharge, and six and twelve months after discharge from the PHP. Descriptive statistics explored markers of feasibility. Paired samples t‐tests evaluated changes in weight and eating disorder (ED) symptomatology from admission to discharge, admission to six‐month follow‐up, and admission to twelve‐month follow‐up. Descriptive statistics and effect sizes compared symptoms at each timepoint between participants with AN and AAN. Results indicated that we were successful at recruiting greater than 50% of adolescents approached for this study. We collected follow‐up data from more than 70% of participants at discharge, but did not meet this retention benchmark at six‐month and twelve‐month follow‐ups. The entire sample demonstrated significant improvements in weight and ED symptomatology from admission to discharge, and generally maintained these improvements at six‐ and twelve‐month follow‐up. While descriptive statistics suggested that participants with AN and AAN received similar outpatient services following discharge from the PHP, those with AN experienced greater improvement in self‐reported ED symptomatology than those with AAN at six‐ and twelve‐month follow‐up. These findings provide preliminary support for the efficacy of PHPs in treating adolescents with AN and AAN. Further research with larger sample sizes should investigate whether adolescents with AAN experience poorer outcomes than those with AN following discharge from a PHP. Key points: Satisfactory benchmarks for recruitment at PHP admission and retention at PHP discharge were met, but these benchmarks were not met at the two follow‐up timepoints. Future studies should utilize improved retention strategies.Preliminary results indicate that adolescents with AN and AAN experienced significant improvements from admission to discharge, further supporting the effectiveness of PHPs for people with AN and AAN.The sample also experienced significant weight increases and ED symptom reductions on all self‐report measures changes from admission to six‐month and twelve‐month follow‐up, suggesting that the treatment gains made in the PHP were generally maintained over time.Descriptively, trends suggest that adolescents with AN and AAN may continue to experience similar increases in %MBMI in the year after discharge from a PHP, but different trajectories of self‐reported ED symptoms, as adolescents with AAN tended to report higher scores on measures of ED symptomatology at follow‐up relative to discharge.This study provides support for the feasibility of a larger study evaluating the effectiveness of a cognitive‐behavioral, family‐centered PHP for adolescents with AN and AAN. Future versions of the study with larger sample sizes should aim to statistically compare differences between outcomes in the AN and AAN groups. [ABSTRACT FROM AUTHOR]

Objective: This study assessed the factorial, divergent, and criterion‐related validity of the Youth‐Nine Item Avoidant/Restrictive Food Intake Disorder (ARFID) Screen (Y‐NIAS) in a paediatric clinical sample at initial evaluation for an eating disorder (ED). Method: Participants included 310 patients (82.9% female, 77.4% White, Age M = 14.65) from a tertiary ED clinic. Confirmatory factor analysis (CFA) evaluated the three‐factor of the Y‐NIAS. One‐way analysis of variance compared Y‐NIAS scores across diagnoses. A receiver operating curve analysis assessed the ability of each subscale to identify ARFID presentations from the full sample. Two logistic regressions assessed the criterion‐related validity of the obtained Y‐NIAS cut‐scores. Results: CFA supported the original three‐factor structure of the Y‐NIAS. Clinically‐elevated scores were observed in all diagnostic groups except for binge‐eating disorder. Subscales were unable to discriminate ARFID cases from other ED diagnoses. Cut scores were identified for picky eating subscale (10) and Fear subscale (9), but not for Appetite subscale. In combination with the ED Examination Questionnaire (EDE‐Q), classification accuracy was moderate for ARFID (62.7%) and other EDs (89.4%). Discussion: The Y‐NIAS demonstrated excellent factorial validity and internal consistency. Findings were mixed regarding the utility of the Y‐NIAS for identifying clinically‐significant ARFID presentations from other ED diagnoses. Key points: The Y‐NIAS demonstrated acceptable factorial validity, internal consistency, and discriminant validity with a measure of weight/shape‐driven disordered eating.Mean scores on the Y‐NIAS subscales did not significantly differ between those diagnosed with Avoidant/Restrictive Food Intake Disorder (ARFID) and those diagnosed with other eating disorders.Cut scores for the picky eating (PE) and Fear subscales with high sensitivity and acceptable specificity were identified, but positive predictive value (PPV) was low.Despite limited ability to discriminate ARFID from other eating disorders, the Y‐NIAS was able to identify clinically‐elevated scores in all diagnostic groups with restrictive eating disorders, indicating that it may have the potential to serve as a transdiagnostic ED screener. [ABSTRACT FROM AUTHOR]

Objective: There is a lack of reliable and valid parent-report measures assessing eating disorder (ED) pathology in children and adolescents. This study aimed to develop and provide preliminary validation of a new parent-report measure, the 12-item Eating Disorder Examination Questionnaire-Short Parent Version (EDE-QS-P). Method: The EDE-QS-P was completed by 296 parents seeking treatment for their child at an ED clinic. Children (ages 6–18, N = 296) completed the Eating Disorder Examination-Questionnaire (EDE-Q), the seven-item Generalized Anxiety Disorder Questionnaire (GAD-7), and the nine-item Patient Health Questionnaire (PHQ-9). Results: After removing item 10, the 11-item version of the EDE-QS-P showed borderline adequate fit to the one factor solution and strong internal consistency (α = 0.91). This measure also demonstrated strong convergent validity with child scores on the EDE-Q (r =.69), and moderate convergent validity with child scores on the GAD-7 (r =.37) and PHQ-9 (r =.46). The EDE-QS-P was able to differentiate children with EDs characterized by body image disturbances (e.g. anorexia nervosa) from those with avoidant/restrictive food intake disorder, who do not experience shape or weight concerns. Discussion: The 11-item EDE-QS-P may be a promising parent-report measure of ED pathology in children and adolescents. [ABSTRACT FROM AUTHOR]

Objective: The COVID‐19 pandemic resulted in a shift from traditional, in‐person treatment to virtual treatment for eating disorders (EDs), with little knowledge about the relative efficacy of virtual formats. Method: In the current study, we examined baseline symptomatology and treatment outcomes of young adults in our virtual partial hospitalization and intensive outpatient program (PHP/IOP) for EDs, implemented shortly after the onset of the COVID‐19 pandemic. We investigated outcomes on body mass index, ED symptoms, anxiety, ED‐related clinical impairment, and emotion regulation. Results: We found significant differences in ED symptomatology, ED‐related clinical impairment, and difficulties with emotion regulation at admission between participants in the virtual and in‐person versions of our PHP/IOP. Despite these differences, the results demonstrated that the degree of change from admission to discharge on these measures was comparable for both conditions. Discussion: These findings suggest that PHPs and IOPs are relatively effective in a virtual format. Providing effective virtual options across various levels of care will improve access to specialized treatment for EDs. Public Significance: (i) Participants in the virtual program reported less severe symptomatology at baseline, (ii) Participants in the virtual and in‐person programs experienced similar improvements, (iii) Virtual programs may be an effective option for young adults with eating disorders. [ABSTRACT FROM AUTHOR]

Objective: Exposure therapy is a promising treatment for eating disorders (EDs). However, questions remain about the effectiveness of exposure to feared foods during the weight restoration phase of treatment, and the importance of between‐session and within‐session habituation. Method: We recruited 54 adolescents from a partial hospitalization program (PHP) for EDs which included daily food exposure. Throughout treatment, participants provided subjective units of distress (SUDS) ratings before and after eating a feared food, and completed measures of ED symptomatology. Results: Multilevel models found that pre‐exposure SUDS decreased over time, providing some evidence that between‐session habituation occurred. In contrast, the difference between pre‐exposure and post‐exposure SUDS did not decrease over time, indicating that within‐session habituation did not occur. Weight gain predicted greater between‐session habituation to feared foods, but did not predict within‐session habituation. Between‐session habituation, but not within‐session habituation, predicted favorable treatment outcomes, including weight gain and improvements on the Children's Eating Attitudes Test and Fear of Food Measure. Discussion: Partial hospitalization programs that include daily exposure to feared foods may be effective at decreasing anxiety about foods for adolescents with EDs who are experiencing weight restoration. Further research is warranted to replicate our findings challenging the importance of within‐session habituation, and to better understand between‐session habituation and inhibitory learning as mechanisms of change when conducting food exposure for EDs. Public Significance: This study provides some evidence that PHPs that include food exposure may be useful for adolescents with EDs who are experiencing weight restoration. Between‐session habituation, but not within‐session habituation, predicted favorable treatment outcomes. Further research is needed to determine whether clinicians can disregard within‐session habituation when conducting food exposure for EDs, and understand the importance of between‐session habituation as a potential mechanism of food exposure. [ABSTRACT FROM AUTHOR]

Objective: This study explored the preliminary effectiveness of a partial hospitalization program (PHP) for children/adolescents with avoidant/restrictive food intake disorder (ARFID). We evaluated how ARFID symptoms changed from admission to discharge, and collected follow‐up data on symptoms and outpatient care following PHP discharge. Method: Twenty‐two children/adolescents with ARFID (77.3% White, 63.6% female) completed measures assessing ARFID symptomatology at admission and discharge from a PHP for eating disorders. Six months and twelve months following their discharge, participants were contacted to complete study measures again and take part in an interview assessing follow‐up care. Results: Paired samples t tests indicated that participants demonstrated increases in weight and decreases in ARFID symptomatology from admission to discharge with medium to large effects. All participants reported receiving some form of outpatient treatment following discharge, with the type of outpatient services varying across participants. Data from the 86% of participants who completed the six‐month follow‐up and 50% who completed the twelve‐month follow‐up suggest that participants generally maintained treatment gains following PHP discharge. Discussion: Participants experienced symptom improvements from admission to discharge and appeared to maintain these gains after discharge. These results provide preliminary evidence that PHPs are an effective treatment option for children and adolescents with ARFID. Public Significance Statement: This study provides preliminary evidence that intensive, evidence‐based PHPs are effective in treating ARFID. Our findings suggest that children and adolescents with ARFID who receive flexible, cognitive‐behavioral, family‐centered treatment in a PHP for EDs experience improvements in weight and ARFID symptomatology from admission to discharge. Despite receiving variable and nonstandardized outpatient treatment, individuals with ARFID appear to maintain treatment gains 6 and 12 months after discharge in a PHP. [ABSTRACT FROM AUTHOR]

Little is known about patients' perceptions toward open and blind weighing for eating disorders. Upon admission to a partial hospitalization program, 35 child/adolescent patients, 55 adult patients, and 36 parents of child/adolescent patients completed questionnaires assessing attitudes toward open and blind weighing. Participants perceived blind weighing as more effective in the short term. No differences emerged on measures assessing preference, credibility, or long-term effectiveness. Relative to adults, parents preferred blind weighing, and child/adolescents perceived blind weighing as more credible. On a forced-choice question, a majority of adults, about half of children/adolescents, and a minority of parents preferred open weighing over blind weighing. There was a positive association between past treatment experience and current attitudes about weighing. Results suggest that individuals enter treatment with variable attitudes about weighing procedures for eating disorders, and may develop more favorable attitudes toward the practice they receive in treatment. [ABSTRACT FROM AUTHOR]

Objective: Exposure therapy appears underutilized in the treatment of eating disorders (EDs), perhaps due to clinicians' concerns that patients will dislike exposure therapy. The present study aims to investigate the attitudes of child patients, adult patients, and parents of child patients with EDs toward exposure therapy relative to four other treatments for EDs. Method: A questionnaire was administered to patients and parents (N = 126) upon admission to a partial hospitalization program for EDs. Participants read vignettes describing five different treatments for EDs, and answered questions assessing attitudes about each treatment. Results: At admission, participants reported the most favorable attitudes toward cognitive therapy, and the least favorable attitudes toward psychiatric medication. Exposure therapy generally received similar scores as interpersonal and expressive art therapy, and was perceived as significantly more preferable and effective in the long‐term than psychiatric medication. Relative to child and adult patients, parents reported greater preferences for all treatments except medication, and perceived all treatments as more credible except medication and art therapy. Preliminary findings from a subset of participants who also completed the questionnaire at discharge indicated that positive attitudes toward exposure therapy increased over the course of treatment. Discussion: Individuals with EDs and their parents may enter treatment with particularly favorable views toward cognitive therapy, and do not appear to have strong attitudes toward exposure therapy one way or the other. Clinicians' concerns that patients with EDs will dislike exposure therapy may be largely unfounded. [ABSTRACT FROM AUTHOR]

Anxiety and eating disorders (EDs) often co‐occur, prompting calls to explore anxiety‐related maintenance processes in ED samples. Safety behaviors, which function to prevent a feared outcome from occurring or to reduce anxiety associated with a feared stimulus, are observed across anxiety disorders and, along with overt avoidance behaviors, are an important target in treatment. Data suggest that individuals with EDs also engage in safety behaviors. However, no existing assessments provide a comprehensive measure of eating‐disorder‐specific overt avoidance and safety behaviors. The goal of this Stage 1 Registered Report is to develop a comprehensive self‐report measure of ED‐specific safety behaviors. In Study 1, we will recruit 50 women with EDs to complete the scale and provide feedback on the response scale. Feedback from these participants will be used to refine the measure. In Study 2, we will evaluate the psychometric properties of the measure in a large sample of women with EDs (n dependent on the size of measurement) and a community sample without current or a history of ED symptoms. We will explore the measure factor structure, known‐groups validity by comparing scores from women with EDs to healthy controls, internal consistency, and convergent and divergent validity with other psychological instruments. [ABSTRACT FROM AUTHOR]

Objective: Picky eating (PE) is common across the lifespan and related to psychosocial impairment and limited dietary variety. However, research about PE in non‐Western countries is limited. Because eating behaviors may differ by culture, operationalizing PE in non‐Western countries (e.g., China) is needed. The present study aimed to replicate two previous studies identifying PE profiles in Western countries by using latent profile analysis (LPA) to classify and characterize adults reporting picky eating in a Chinese sample. Method: A sample of 1,068 Chinese young adults completed a battery of questionnaires including the adult eating behavior questionnaire (AEBQ). LPA was utilized to identify eating profiles. The three‐step approach was used to examine predictors of latent memberships and profile differences on various self‐reported measures. Results: The best fit was a four‐profile solution, with two picky eating profiles emerging: picky eating and severe picky eating. Compared to those in the other two profiles, participants in the picky eating profile (19.4%) and severe picky eating profile (3.3%) had significantly higher scores on self‐reported eating disorder symptoms and psychological distress, and lower scores on self‐reported food‐related life satisfaction. Relative to the picky eating profile, participants in the severe picky eating profile reported significantly greater self‐reported eating disorder symptoms, psychological distress, and food‐related dissatisfaction. Discussion: Characterizing PE profiles is an important step toward understanding eating behaviors among Chinese young adults. Identifying various eating profiles has implications for future research related to PE, including the development of diagnostic tools and interventions to address PE in a Chinese context. [ABSTRACT FROM AUTHOR]

Measurement-based care (MBC) is an evidence-based approach to improving outcomes of mental health services. There is considerable interest in implementing it in clinical practice settings. However, relatively little attention has been paid to the pragmatics of developing and implementing MBC in youth mental health. This paper describes one effort to accomplish this goal. After a brief discussion of the advantages of MBC, the process, and initial implementation of the Penn State Psychiatry Clinical Assessment and Rating Evaluation System for Youth (PCARES-Youth) is described. Results of a pilot project of PCARES-Youth are presented, including a survey of clinicians about their experiences with the initiative. Finally, lessons learned and next steps of the project are discussed. [ABSTRACT FROM AUTHOR]

Objective: To identify potential presentations of avoidant/restrictive food intake disorder (ARFID) in a pediatric eating disorder partial hospitalization program (PHP) based on the nature of the eating restriction leading to core symptoms of ARFID. Method: A retrospective chart review of 83 patients ages 8–17 admitted to a PHP and diagnosed with ARFID. Charts were independently reviewed by two coders, with high inter‐rater agreement (κ = 0.77). Distinct categories were identified and groups were compared on demographics, anthropometrics, comorbid psychopathology, and core ARFID symptoms. Results: We identified cases characterized by predominantly selective eating based on aversions to the sensory properties of foods, lack of interest in eating/low appetite, and fear of aversive consequences from eating. We also distinguished a subset of patients with eating restrictions consistent with both selectivity and limited interest/appetite. The four primary ARFID presentation groups differed on core ARFID criteria, symptom trajectory and illness duration, mood and medical comorbidities, age, gender, and parent‐reported symptoms of psychopathology. Discussion: The present findings suggest that there are diagnostically meaningful ARFID subtypes that can be differentiated based on the nature of their eating restrictions, as well as other demographic, illness history features, and psychiatric comorbidity. As treatments for youth with ARFID are developed and refined, it will be important to take into consideration not only demographic differences, but also the variability in symptoms, as this might require distinct interventions and levels of care. Additionally, differing mechanisms that maintain different types of eating restrictions might necessitate unique psychological and psychiatric interventions. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To assess long‐term outcomes of patients with avoidant/restrictive food intake disorder (ARFID) treated in a partial hospitalization program (PHP) for eating disorders (ED). Method: A cross‐sectional study comparing patients with ARFID to those with anorexia nervosa (AN) who had been discharged from a PHP for at least 12 months was performed. Percent median body mass index (%MBMI), scores on the Children's Eating Attitudes Test (ChEAT), and treatment utilization were assessed, with intake and discharge data collected via retrospective chart review. Results: Of the 137 eligible patients, 62 (45.3%) consented to follow‐up data collection. Patients with ARFID and AN exhibited similar increases in %MBMI from intake to discharge and reported low scores on the ChEAT by discharge. Patients with ARFID and AN maintained good weight outcomes and low ChEAT scores at follow‐up. Most participants were still receiving outpatient treatment from a variety of providers, although fewer with ARFID than AN continued to receive services from our multidisciplinary ED clinic. Discussion: Patients with ARFID and AN exhibit similar improvements in %MBMI when treated in the same PHP and appear to maintain treatment gains at long‐term follow‐up. Additionally, most patients continue to utilize outpatient services after being discharged from a PHP. [ABSTRACT FROM AUTHOR]

Little is known about which specific weight management skills bariatric patients find most and least valuable. Participants completed a measure assessing their usage of weight management skills at a follow-up appointment one or more years after undergoing bariatric surgery. Decreased usage of skills was associated with unsuccessful weight outcome, defined as losing less than 50% of excess weight, as well as weight regain. Weighing regularly was the skill selected most often by successful participants as helpful, and was chosen by a significantly smaller percentage of unsuccessful participants and those who regained a clinically significant amount of weight. A majority of both successful and unsuccessful participants indicated that they had discontinued food journaling. Weighing regularly may be perceived as a more useful method of self-monitoring. [ABSTRACT FROM AUTHOR]

Purpose: To explore the psychological impact of weight labels.Design: A double-blind experiment that randomly informed participants that they were "normal weight" or "overweight."Setting: Public university in Honolulu, Hawai'i.Participants: Normal-weight and overweight female undergraduates (N = 113).Measures: The Body Image States Scale, Stunkard Rating Scale, Weight Bias Internalization Scale, Positive and Negative Affect Schedule, General Health question from the 12-item Short Form Health Survey, modified version of the Weight Loss Methods Scale, and a manipulation check.Analysis: A 2 × 2 between-subjects analysis of variance explored the main effects of the assigned weight label and actual weight and interactions between assigned weight label and actual weight.Results: Significant main effects of the assigned weight label emerged on measures of body dissatisfaction, F(1, 109) = 12.40, p = .001, [Formula: see text] = 0.10, internalized weight stigma, F(1, 108) = 4.35, p = .039, [Formula: see text] = .04, and negative affect, F(1, 108) = 9.22, p = .003, [Formula: see text] = .08. Significant assigned weight label × actual weight interactions were found on measures of perceived body image, F(1, 109) = 6.29, p = .014, [Formula: see text] = .06, and perceived health, F(1, 109) = 4.18, p = .043, [Formula: see text] = .04.Conclusion: A weight label of "overweight" may have negative psychological consequences, particularly for overweight women. [ABSTRACT FROM AUTHOR]

Recent reviews have challenged the view that gay men are at higher risk than heterosexual men for developing poor body image. The current project examined the extent to which gay and heterosexual men differed on measures related to body image. We also examined whether body mass index (BMI) moderated the association between sexual orientation and body image. Across 5 studies, 111,958 heterosexual men and 4,398 gay men completed surveys assessing different aspects of body image. Gay men generally reported lower body satisfaction than heterosexual men, but these differences were typically small (most ds < .20). Gay men were more likely than heterosexual men to report dissatisfaction with their physical appearance (29 vs. 21%) and muscle size/tone (45 vs. 30%), but not weight (44 vs. 39%). Gay men were also more likely to agree that they experienced objectification (d = .40; 77% agree vs. 61% agree), surveillance (d = .50; 58 vs. 39%), appearance-based social comparison (d -- .45; 68 vs. 51%), and pressure from the media to be attractive (d = .68; 58 vs. 29%). Odds ratios showed that gay men were more likely to consider cosmetic surgery (3.96), use diet pills (2.59), diet in the past year to lose weight (1.84), and avoid sex because of body dissatisfaction (6.28). BMI was a strong predictor of body dissatisfaction in men, but did not consistently moderate the association between sexual orientation and body image. Differences between heterosexual and gay men were largest on measures assessing body modification and perceived sociocultural pressures. [ABSTRACT FROM AUTHOR]

Objective: Research has indicated that adult picky eating (PE) is associated with elevated psychosocial impairment and limited dietary variety and fruit and vegetable intake; however, research operationalizing PE behaviors is limited. Previous research identified a PE profile in children, marked by high food avoidance (satiety responsiveness, fussiness, and slow eating) and low food approach (food enjoyment and responsiveness) appetitive traits. The present study aimed to replicate a similar latent eating behavior profile in an adult sample. Methods: A sample of 1339 US adults recruited through Amazon's MTurk completed an online survey that included a modified self-report version of the Child Eating Behavior Questionnaire (CEBQ-A). Latent profile analysis was employed to identify eating profiles using the CEBQ-A subscales, ANCOVAs were employed to examine profile differences on various self-report measures, and eating profiles were compared across BMI classifications. Results: Analyses converged on a four-profile solution, and a picky eater profile that closely resembled the past child profile emerged. Participants in the picky eater profile (18.1%) scored higher on measures of adult PE and social eating anxiety compared to all other profiles, scored higher on eating-related impairment and depression than moderate eating profiles, and were more likely to be of normal weight. Discussion: A distinct adult PE profile was observed, indicating childhood PE and appetitive behaviors may carry over into adulthood. Research identifying meaningful groups of picky eaters will help to shed light on the conditions under which picky eating is a risk factor for significant psychosocial impairment or distress, or weight-related problems. [ABSTRACT FROM AUTHOR]

The Fear of Food Measure (FOFM) was developed to assess eating-related anxiety and evaluate outcomes of food exposure treatment. The FOFM scores in adult community and clinical samples have demonstrated good factor structure, reliability, and validity, but the FOFM has yet to be evaluated in adolescents, despite eating disorders (EDs) being extremely prevalent during adolescence. The current research evaluated the psychometric properties of the FOFM in three independent child and adolescent samples ages 11–18: patients at two separate intensive treatment programs for EDs (N = 688, N = 151) and students in an all-girl high school (N = 310). The revised adolescent version of FOFM (FOFM-A) consists of 10 items and three subscales: Anxiety About Eating, Food Anxiety Rules, and Social Eating Anxiety. We also found support for the use of a global FOFM-A score in an adolescent population. The FOFM-A scores evidenced good internal consistency as well as convergent, discriminant, and incremental validity across all samples. FOFM-A subscales strongly correlated with other measures of ED symptoms and moderately to strongly correlated with measures of anxiety and depression. Adolescents diagnosed with EDs scored significantly higher on all subscales of FOFM-A compared to a community high school sample without ED diagnoses. We identified that a total FOFM-A cutoff score of 1.93 best differentiates between those with and without ED diagnoses. The FOFM-A may be useful in the assessment and treatment of eating-related anxiety and avoidance in adolescents. Public Significance Statement: The study provides evidence for reliability and validity of the scores of the Fear of Food Measure adapted to adolescents (FOFM-A). The FOFM-A can be used to access eating-related anxiety in adolescents with and without an ED diagnosis and help assess outcomes of exposure-informed treatment programs. [ABSTRACT FROM AUTHOR]

The present study explores the perceived sexual orientation of hypothetical men and women with various eating disorders and obesity. Undergraduates were randomly provided with one vignette describing a male or female with anorexia nervosa (AN), bulimia nervosa (BN), binge-eating disorder, or obesity and were asked about the target's likely sexual orientation. Significant differences emerged between male and female targets with AN and BN on the forced-choice question, with a greater percentage of participants indicating that the male targets were probably non-heterosexual. On continuous items, participants rated the female targets as significantly more likely to be heterosexual and significantly less likely to be homosexual than male targets. The general public may be more likely to perceive men with eating disorders as gay or bisexual relative to females with eating disorders. Perceived sexual orientation might be an important factor to consider when exploring the potentially unique perspectives of men with eating disorders.