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The role of traditional media (television and magazines) in creating eating disorder risk has long been a topic of discussion and research, but the proliferation of social media and rapid increase in the use of the Internet by adolescents generates new dynamics and new risks for the development and maintenance of eating disorders. Recent research describes the relationship between Internet and social media use and eating disorders risk, with the greatest associations found among youth with high levels of engagement and investment in photo-based activities and platforms. Here, we review different types of online content and how they are relevant to eating disorders and consider the theoretical frameworks predicting relationships between Internet and social media and eating disorders, before examining the empirical evidence for the risks posed by the online content in the development and maintenance of eating disorders. We describe proeating disorder content specifically and examine the research related to it; we then consider the implications of such content, highlight directions for future research, and discuss possible prevention and intervention strategies.

Standardized developmentally based assessment systems have transformed the capacity to identify transdiagnostic behavioral markers of mental disorder risk in early childhood, notably, clinically significant irritability and externalizing behaviors. However, behavior-based instruments that both differentiate risk for persistent psychopathology from normative misbehavior, and are feasible for community clinicians to implement, are in nascent phases of development. Young children’s facial expressions during frustration challenges may form the basis for novel assessments tools that are flexible, quick, and easy to implement as markers of psychopathology to complement validated questionnaires. However, the accuracy of facial expressions to correctly classify young children falling above and below clinical cut-offs is unknown. Our goal was to test how facial expressions during frustration, defined by different facial muscular movements, related to individual differences in irritability and externalizing behaviors and discriminated children with clinically significant levels from peers. Participants were 79 children (ages 3–7) who completed a short, moderately frustrating computer task while facial expressions were recorded. Only negative facial expressions that included eye constriction related to irritability and externalizing behaviors and were clinically discriminating. Moreover, these expressions significantly discriminated children with and without clinically significant irritability and externalizing symptoms with high Area Under the Curve (AUC) values (> .75) indicating good clinical utility. In contrast, expressions without eye constriction showed no clinical utility. The presence of negative expressions with eye constriction in response to a short frustration prompt may serve as an indicator of early psychopathology, raising the potential for novel assessment tools that may enhance precision of early identification.

Veterans using civilian health care may suffer from undiagnosed posttraumatic stress disorder and have barriers to care. Through a primary care and nonprofit partnership, we trialed a posttraumatic stress disorder risk screening tool and referral process. Of almost 850 screened patients, 100 self-identified as veterans. Of those, 15 were deemed at-risk and referred, and 13 requested and received services from the nonprofit. Postimplementation feedback from staff and provider focus groups was positive, but inconsistent screening compliance and nonprofit organizational instability were barriers to optimal implementation and evaluation.

Low-back disorder risk can be modulated by pelvis-thorax coordination when lifting. To objectively discriminate between coordination patterns during lifting, the analytical methods used require evaluation. The primary study objective was to determine if continuous relative phase (CRP) and vector coding (VC) analyses can discriminate between lifting techniques that differ based on biomechanical risk criteria. The secondary objective was to determine if normalization/transformation of input segmental angular position and velocity data is required to discriminate between lifting techniques. Sixteen volunteers performed a sagittal lifting task using freestyle (FRE), flexed spine (FLX), and neutral spine (NTL) techniques. CRP and VC analyses were implemented to quantify pelvis-thorax coordination patterns based on time-normalized, phase-normalized, and Hilbert-transformed segmental angular kinematic data. Mean relative phase angles along with thorax-only and in-phase coupling patterns were significantly different between FRE-NTL and FLX-NTL techniques (p 0.01), but not FRE-FLX (p 0.44). This finding was consistent across all relative phase normalization/transformation methods. Therefore, CRP and VC analyses successfully discriminated between different lifting techniques, regardless of the relative phase normalization/transformation method used.

The goal of this systematic review and meta-analysis was to evaluate the efficacy of mindfulness-based eating disorder prevention programs. Twenty articles met all inclusion and exclusion criteria, including 15 randomized studies (2173 participants) that were included in the meta-analysis. Compared to wait-list controls, mindfulness-based programs were found to significantly reduce participants’ body image concerns and negative affect and improve body appreciation at post-intervention. Compared to cognitive-dissonance programs, mindfulness-based programs were found to significantly improve participants’ self-esteem at post-intervention. There were no significant differences between groups on any other outcome, and no significant differences on any outcome at long-term follow-up. Selective prevention programs and programs that incorporated meditation as the primary intervention type had the largest effect sizes. While the conclusions that can be drawn are limited by both the quantity and quality of available research, results of this review suggest that mindfulness-based eating disorder prevention programs may reduce eating disorder risk factors and increase protective factors.

Summary This article explores the challenges associated with diagnosing and managing eating disorders such as anorexia nervosa amongst adolescents and adults with cystic fibrosis. It reviews the known risk factors, generic verses disease specific eating disorder risk screening tools and considers the ethical dilemmas associated with critically low body mass indices. A case review is included to illustrate the complexities of managing both conditions in the context of declining respiratory function.

Physiological storage disorders affect a range of commercially important pomefruit and result in fruit losses and wastage of resources. Disorders can develop during and/or after storage and symptoms are strongly influenced by the growing environment and orchard management. Furthermore, fruit which receive similar orchard management and storage can vary greatly in disorder incidence and severity. Biological systems are complex and simple cause-and-effect approaches have not up until now resulted in robust methods to predict disorder risk. Reliable predictions are needed by fruit industries worldwide to better manage fruit production processes, to determine optimal harvest dates and long-term storage regimes. The current work proposes a new methodological approach to model ‘Braeburn’ apple disorder risk. Autoregressive time series (ARX) models via model identification techniques for chlorophyll, anthocyanins, soluble solids and dry matter content were obtained from weather conditions and different orchard management treatments and then served as input into a classifier for internal browning, cavities and fruit firmness after long-term controlled atmosphere storage. The classification results for internal browning disorder show a 90% agreement between two separate years and for fruit firmness an 80% success rate was obtained by training the classifier with two years of data.

Objective The purpose of this study was to test whether pre-treatment levels of psychological flexibility would longitudinally predict quality of life and eating disorder risk in patients at a residential treatment facility for eating disorders. Method Data on body image psychological flexibility, quality of life, and eating disorder risk were collected from 63 adolescent and 50 adult, female, residential patients (N = 113) diagnosed with an eating disorder. These same measures were again collected at post-treatment. Sequential multiple regression analyses were performed to test whether pre-treatment levels of psychological flexibility longitudinally predicted quality of life and eating disorder risk after controlling for age and baseline effects. Results Pre-treatment psychological flexibility significantly predicted post-treatment quality of life with approximately 19% of the variation being attributable to age and pre-treatment psychological flexibility. Pre-treatment psychological flexibility also significantly predicted post-treatment eating disorder risk with nearly 30% of the variation attributed to age and pre-treatment psychological flexibility. Discussion This study suggests that levels of psychological flexibility upon entering treatment for an eating disorder longitudinally predict eating disorder outcome and quality of life.

In this study, the summertime outdoor heat stress hazard and heat disorder risk (HDR) were simulated, and their changes under several heat island mitigation scenarios were quantitatively evaluated. Gridded maps that included the 23 wards of Tokyo (23 Tokyo) were produced with 1-km horizontal resolution for consecutive summer months, facing extremely hot weathers, in 2010. The wet-bulb globe temperature (WBGT) was adopted as an outdoor heat stress indicator. Numerical simulations were applied to evaluate the effects of several heat island mitigation scenarios—including building greening (GR), high-albedo coating (ALB), and roof-level emissions of all waste heat by air conditioning (WH)—on the WBGT and HDR for 23 Tokyo. Results showed no cases that effectively lowered the outdoor WBGT and HDR for the studied region. Conversely, the ALB case increased the daily maximum WBGT by an average of 0.6 °C (maximum of 1.7 °C) over all the grids. This increase induced a 1.4 (3.3) times higher HDR in the area average (at the maximum grid) compared to a control case with no mitigation scenario. Hence, heat island mitigation methods reflecting solar radiation could potentially lead to an increase in the outdoor heat stress hazard and risk to a large extent in urban areas.

OBJECTIVES: Adherence to popular diets has increased in recent years. This is concerning as extreme dieting behaviors, which may develop as a result of following certain diets, can increase risk for developing an eating disorder (ED). We assessed whether adherence to popular diets (i.e., gluten free, vegetarian, paleo, and clean eating) is related to ED diagnosis and severity. We hypothesized that adherence to any popular diet would be associated with ED risk, while adherence to an increasing number of diets would be associated with ED severity. METHODS: Adult women admitted to an intensive outpatient or partial hospitalization program for ED treatment were recruited to participate. Demographic information (age and race), ED diagnosis and severity (identified by a trained clinician and scored by the Eating Disorder Inventory 3 (EDI-3)), and height and weight were collected. A self-administered survey assessed diet history. RESULTS: Seventy-seven women aged 26.74 years (SD = 7.71), primarily white (89.6%), with an ED diagnosis (48.1% anorexia nervosa (AN); 20.8% bulimia nervosa (BN), 16.9% binge eating disorder (BED), and 14.3% “eating disorder not otherwise specified” (EDNOS)) participated. The majority (63.6%) reported currently or previously following a minimum of one pre-selected diet and 7.8% indicated following all four diets at some time point. Diet history was related to ED diagnosis (x2 = 15.981, P = 0.014), particularly among participants diagnosed with AN, BN, or EDNOS. Adherence to specific diets, including gluten free or vegetarian, was not associated with ED diagnosis (x(2) = 11.422, P = 0.076 and x(2) = 7.789, P = 0.254, respectively), although adherence to paleo and clean eating were more commonly followed by participants diagnosed with EDNOS (x(2) = 9.419, P = 0.151 and x(2) = 12.307, P = 0.055, respectively). Paleo diets were significantly associated with 3 of the 6 EDI-3 composite scores (P

The aim of this experiment was to examine the extent to which eating disorder risk affects the strength of food-reward conditioning. Eighty food-restricted undergraduates were placed into a VR environment consisting of two visually distinct rooms. Participants underwent multiple pairing sessions in which they were confined into one of the two rooms and explored a VR environment. Room A was paired with real-life MMs for three sessions, and Room B was paired with no food for three sessions. After a short delay, a test session was administered, and participants were given free access to the entire VR environment for 5 min. Participants also completed the Eating Attitudes Test (EAT-26; [11]), which is a standard screening tool of eating disorder risk. Participants displayed a significant conditioned place preference for the VR room previously paired with food, and they displayed a significant explicit preference for the MM-paired room in a forced-choice test. There was a significant positive correlation between place preference strength and scores on the dieting subscale of the EAT-26. Additionally, ratings of the no-food room were significantly lower as dieting scores increased. This suggests that components of eating disorder risk can influence basic conditioning strength to places associated with food reward. For both males and females, additional correlations between eating disorder risk subscales and conditioning variables are discussed, and implications for future research are proposed in hopes of understanding how conditioning paradigms can provide insight into treating and preventing eating disorders.

Study objectives The absence of a screening questionnaire for delayed sleep phase disorder (DSPD) remains a barrier to its detection and subsequent clinical evaluation. We developed a questionnaire to screen for DSPD risk and assessed its impact on self-reported absenteeism and functioning in work/school, social, and family life. Design Cross-sectional, with 13,844 individuals responding to a survey through an Internet survey provider, from which 1315 completed surveys were obtained from eligible participants. Participants A total of 1315 individuals who self-identified as evening type (n = 979) or as non-evening type (n = 356). Measurements and results A total of 295 participants were at high risk for DSPD, which is 5.1% of the total eligible survey respondents and 22.4% of our final sample with completed surveys. Compared to those who were not at high risk for DSPD, those who were at high risk were more likely to report frequent absenteeism, frequent loss of productivity, disruption to work or school activities, disruption to social life or leisure activities, and disruption to family life or home responsibilities. Difficulty with daytime sleepiness was more common in those at high risk for DSPD than those who were not. Increased sleep deficit on nights before school or work was also associated with more frequent difficulties with daytime sleepiness; 15.4% of those with no sleep deficit reported always or usually having difficulties with daytime sleepiness compared to 55.7% of those with a sleep deficit of 3 hours or more. Conclusions DSPD risk is associated with increased absenteeism and impaired functioning in work/school, social, and family life.

Background While a great amount of attention has been paid to early-onset obsessive-compulsive disorder (OCD), there is a dearth of studies on patients showing OCD for the first time at later stages of life. In this study, we aimed at determining possible risk factors/correlates for OCD onset at or after age 40, here termed late-onset OCD. Method A series of models including several potential variables associated with late onset OCD were tested using a monolayer neural network. To this regard, data from the Brazilian Research Consortium of Obsessive-Compulsive Spectrum Disorders (CTOC) (n = 1001) was employed. For the purposes of this study, we considered a diagnosis of late onset OCD to be present whenever distress and interference associated with OCD symptoms emerged at or after age 40. Different nested models were compared through the Akaike Criteria keeping the variables with p value ≤0.05. Results Late-onset OCD occurred in 8.6% of the sample. A model including female sex, a history of chronic (>10 years) subclinical obsessive-compulsive symptoms, the co-occurrence of posttraumatic stress disorder (PTSD) after age 40, and a history of recent pregnancy in self or significant others was able to explain a sizeable proportion of late-onset OCD. The general performance of this model, represented by the Maximum Likelihood R2, was 29.4%. Conclusion Our results suggest that late-onset OCD is more likely to occur in females, in individuals with long periods of subclinical obsessive-compulsive symptoms, and in association with a major traumatic event occurring after age 40 and a history of recent pregnancy in self or in significant others.

In the field of eating disorders, much research has been devoted to selective prevention that addresses high-risk groups, while universal prevention has received less attention. This paper systematically reviews recent studies on the universal prevention of ED. The analysis shows that universal prevention may impact on a wide range of eating disorder risk factors such as body dissatisfaction and media internalization. However, no study has investigated later presence or absence of ED. We conclude that additional research is needed to shed more light on the long-term effects and the actual onset of ED. “Booster-sessions” in the years following the intervention might aid in sustaining the gains.

This paper describes the prevalence of eating disorders and disordered eating behaviors, the reasons why these practices are endorsed, and the potential consequences in youths and young adults with selected diet-related chronic health conditions (DRCHCs) and provides recommendations for eating disorder prevention interventions and research efforts. Although it remains unclear whether the prevalence of eating disorders is higher in those with DRCHCs compared with the general population, overall findings suggest that young people with DRCHCs may be at risk of endorsing disordered eating behaviors that may lead to diagnosis of an eating disorder and other health problems over the course of their treatment. Thus, health care providers should be aware that young people with DRCHCs may be at risk of eating disorders and carefully monitor psychological changes and the use of unhealthy weight control methods. It is also important to develop and evaluate theory-based interventions and disease-specific eating disorder risk screening tools that are effective in halting the progression of eating disorders and negative health outcomes in young people with chronic health conditions.

The Eating Disorder Risk Composite (EDRC) comprises the Drive for Thinness, Bulimia, and Body Dissatisfaction subscales of the Eating Disorder Inventory, Third Edition (EDI-3, Garner, 2004). Past research conducted with Latina college women (LCW) has found older versions of the EDRC subscales to be reliable, but the EDI-3’s EDRC factor structure has yet to be studied among LCW. The present study investigated the pattern of responses to and the factor structure of the EDRC in LCW. It was hypothesized that eating pathology would be present and that a factor analysis would find some discrepancies between the original factor structure of the EDRC and the factor structure from LCW. Analyses of data on a 6-point Likert scale indicate that drive for thinness and body dissatisfaction are far more prevalent than is bulimic symptomology in LCW. Principal Axis Factoring with promax rotation was used to extract three factors very similar to the original EDRC. Some discrepancies in the item loadings were observed, most notably that half of the items from the original Body Dissatisfaction subscale did not load together on one factor. Overall, the EDRC appears to be a good measurement of eating- and body-related phenomena among LCW. Implications, limitations, and future directions are discussed.

This study tested a brief eating disorder risk measure, originally developed for use with college students, in young adolescents. The measure is called the COEDS (College Eating Disorders Screen) and is constructed of items written in everyday language used by youth to discuss weight issues, rather than in the language of symptom assessment. A sample of 246 early adolescents (mean age, 13) completed questionnaire measures of puberty, eating disorder behavior, and eating disorder risk two times in a 12-month span. We found that: (a) the COEDS was internally consistent; (b) COEDS scores were stable across one year; and (c) COEDS scores predicted restricting and compensatory behavior one year later, above and beyond prediction from sex, race, prior restricting and compensatory behavior, and prior BMI. The COEDS appears to be a reliable and valid measure for risk assessment in youth; it may prove useful for researchers and clinicians interested in screening for risk and as a means to test whether prevention efforts have reduced risk.

Objectives: To present a profile of eating disorder risk among figure skaters by (a) comparing somatotype and BMI as biological variables in explaining Eating Disorder Inventory (EDI) variance; (b) examining relationships among physical characteristics, physique-related perceptions, and psychological indicators of eating disorders, and (c) determining if a composite of physical and psychological variables could discriminate solo skaters from dance and pair skaters. Design: Cross-sectional. Methods: A battery of anthropometric dimensions was taken, and the Physical Self Description Questionnaire, Social Physique Anxiety Scale, and EDI were completed by 114 competitive female figure skaters 12–22 yrs of age. Results: Correlation analyses indicated that the BMI was the most robust biological variable for subsequent analyses. Using hierarchical stepwise regression analysis to determine if physical self-perceptions predicted EDI subscale score, age was forced into each analysis at the first step followed by the BMI at step two. A composite of psychological variables (SPAS and select PSDQ subscales) were randomly entered at step three. Beyond age and the BMI, each of the EDI subscales was predicted by at least one psychological variable, with the SPAS predicting six of the eight subscales. Physical and psychological variables accounted for 3% to 63% of the variance in the EDI subscale scores. Dancers and pair skaters were older and less endomorphic, and reported higher Health scores, but lower Appearance scores compared to solo skaters. Conclusion: Contextual, physical and psychological variables appear to be germane features of eating disorder risk among competitive adolescent female figure skaters.

This study examined whether elevations on four variables (drive for thinness, depressed mood, maladaptive cognitions, and ineffectiveness) were related to increased severity of eating disorder symptoms over a 4-year prospective interval in a sample of female undergraduates (N=80). Results indicated that initial scores on the four variables were related to severity of anorexic and bulimic symptoms 4 years later. Examination of each variable individually indicated that anorexia and bulimia may have different risk pathways, and that initial maladaptive cognitions and drive for thinness scores were more related to later eating disorder symptoms than were depressed mood or ineffectiveness.

Background The evidence for vulnerability and resilience as responses to traumatic events points to a range of long-term effects following trauma. The factors that modify the adaptation to trauma include the environment and prior experience. This study compares recent work in the field of neuroscience, particularly the application of epigenetic methods to trauma studies, with findings related to the transformative power of trauma narratives. Methods The Transcending Trauma Project has collected and analyzed 300 in-depth narratives of Holocaust survivors and their family members. Our approach points to the influence of narratives shared about the memories of trauma on shaping the worldview of those who listen. The Transcending Trauma Project team has focused on the comprehensive study of coping and adaptation after extreme trauma through the expansion of current paradigms by applying the principles of qualitative research to the study of a large sample consisting of family units comprised of intergenerational members of the same family. The challenge we faced included devising methods for the management of a large data set and methods for assessing qualitative narrative material on the individual and family system levels. Our observations are compatible with recent epigenetic modifications that have been shown to correlate with the intergenerational transmission of posttraumatic stress disorder risk. Results When a particular attribute of a survivor parent is emotionally compelling, this attribute can become an organizing value system in the identity of the child. We have framed the process as the communication of transformative narratives. Integrating epigenetics into a model that probes the mechanisms through which the meaning of prior experience is expressed and transmitted is consistent with the approach we have used to trace the impact of pivotal narratives. Discussion Through this analysis, we underline the importance of a developmental view that evaluates the complex biological and psychological processes that contain both the elements of positive adaptation and negative consequences as they are experienced by trauma survivors and their offspring